Estudo da incidência de candidemia e diversidade genética de Candida em pessoas internadas em Unidades Hospitalares de Manaus - Amazonas

Abstract

Candidemia is a bloodstream infection caused by Candida. Its incidence varies between 1.27 and 3.9 cases per 1000 admissions in Brazil and from 0.29 to 1.95 cases per 1,000 admissions in the world. C. albicans is the main agent with an incidence ranging from 25.9 % to 59 %. This study aimed to determine the incidence of candidemia in 11 Hospital Units Manaus (public and private) and to determine the genetic diversity among isolates of Candida albicans and identify the existence of cryptic species Candida parapsilosis complex. The C. albicans isolates were subjected to molecular typing technique for multilocus sequencing (MLST) and identified as C. parapsilosis, were subjected to PCR/RFLP. Altogether 101 isolates were studied of the genus Candida. The overall incidence was found to be 2.31 cases per 1,000 admissions and 0.61 cases per 1000 patients/day. The genus Candida was the second cause of bloodstream infections in the studied hospitals, representing 8.6 % of all cases. The most prevalent species was Candida albicans representing 35.64 % of the cases followed by Candida tropicalis with 30.69 %. The male (68,24 %) was most affected by these infections than females (31,76 %). The overall mortality rate was 37.21 % and the species with the highest mortality rates Candida tropicalis was 53.85%. 58 different alleles were identified by the technique of MLST and one allele for the gene SYA1 has been set as a new allele. Their combinations represented 25 different genotypes, of which 15 were identified as new genotypes and sent to the curator for analysis. Of the 22 isolates originally described as C. parapsilosis, three were reidentified as C. orthopsilosis and C. metapsilosis. Of the 25 genotypes found for C. albicans was the main STD 90 and this data differ from the data found in Brazil and in the world , pointing DST 69 as the most common . Were identified for the first time in our region , blood stream infections by C. parapsilosis cryptic species complex with three cases of C. orthopsilosis and one case of C. metapsilosis.