Epidemiología de la candidemia en el Hospital México

Autores/as

  • Juan Manuel Villalobos Vindas Caja Costarricense del Seguro Social, Hospital México
  • José Antonio Castro Cordero Caja Costarricense del Seguro Social, Hospital México
  • Álvaro Avilés Montoya Caja Costarricense del Seguro Social, Hospital México
  • María Claudia Peláez Gil Caja Costarricense del Seguro Social, Hospital México
  • Teresita Somogyi Pérez Caja Costarricense del Seguro Social, Hospital México
  • Lilliana Sandoval Carpio Caja Costarricense del Seguro Social, Hospital México

DOI:

https://doi.org/10.51481/amc.v58i1.908

Palabras clave:

Candida parapsilosis, candidemia, fungemia, sepsis, síndrome de respuesta inflamatoria sistémica

Resumen

Justificación y objetivos: las infecciones invasivas por Candida son frecuentes y de alta mortalidad en la práctica clínica. Existe poca información publicada al respecto en el país. Estudio retrospectivo y observacional que pretende aportar conocimiento novedoso sobre la epidemiología local de la candidemia.

Métodos: se incluyó 136 pacientes mayores de 17 años en su primer episodio de candidemia, internados en el Hospital México, entre 2007 y 2010. Se realizó un análisis descriptivo y temporal, se evaluaron los factores asociados con C. parapsilosis y con la sobrevida a 30 días.

Resultados: se detectó en promedio 34 episodios por año (rango 27 a 51), la incidencia acumulada fue de 1,1 casos/1000 admisiones. Las especies de Candida no albicans constituyeron el 62% de las levaduras aisladas. Exceptuando 2009, C. parapsilosis fue la especie predominante en 3 de 4 años estudiados (41%), seguida por C. albicans (38%). Se demostró una fuerte asociación entre la candidemia por C. parapsilosis, la presencia de catéter venoso central (OR=19,6, IC95%: 2,6 a 403,8, p<0,001) y el uso de nutrición parenteral (p=0,014). La mortalidad a 30 días fue del 46%. C. albicans mostró la mortalidad más alta y C. parapsilosis, la más baja. Los pacientes que no recibieron tratamiento antifúngico presentaron una probabilidad significativamente mayor de morir.

Conclusiones: la elevada incidencia de candidemia por C. parapsilosis está directamente relacionada con los catéteres venosos centrales y el uso de nutrición parenteral; su marcada reducción en la frecuencia durante 2009, merece ser investigada para dilucidar los factores que provocaron este cambio.

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Publicado

2016-02-02 — Actualizado el 2016-02-02

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Cómo citar

Vindas, J. M. V., Cordero, J. A. C., Montoya, Álvaro A., Gil, M. C. P., Pérez, T. S., & Carpio, L. S. (2016). Epidemiología de la candidemia en el Hospital México. Acta Médica Costarricense, 58(1), 15–21. https://doi.org/10.51481/amc.v58i1.908

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