Caracterización de Candida spp. aislado del torrente sanguíneo en un hospital de referencia en Brasil: uso de MALDI-TOF/MS para identificar especies inusuales de Candida
DOI:
https://doi.org/10.33448/rsd-v11i11.33243Palabras clave:
Candidemia; MALDI-TOF/MS; Antifúngicos; Mortalidad.Resumen
La candidemia es un problema de salud con una alta tasa de mortalidad. Los objetivos de este estudio fueron comparar la identificación de Candida spp. mediante metodologías tradicionales y espectrometría de masas (MALDI-TOF/MS), para verificar el perfil de susceptibilidad antifúngica de estos aislados y analizar la evolución clínica de los pacientes. Se trata de una cohorte prospectiva de dos años realizada en el Hospital de Clínicas de Uberlândia (HCU-UFU). Candida spp. fueron identificados usando VITEK®-2 y MALDI-TOF/MS. Las pruebas de susceptibilidad antifúngica se realizaron a través de VITEK®-2. Los datos clínico-demográficos se evaluaron a partir de las historias clínicas y las variables se describieron como media, desviación estándar, frecuencia y porcentaje; los factores de riesgo se evaluaron mediante análisis univariado y multivariado. Un total de 113 pacientes y 126 Candida spp. fueron estudiados. C. albicans fue la más frecuente (30%); MALDI-TOF/MS identificó especies inusuales, incluida la identificación errónea de C. famata. La mayoría de los aislamientos (95%) fueron sensibles a los antifúngicos probados. La mayoría de los pacientes eran hombres (65%) y mayores de 60 años (45%); El 85% de los pacientes fueron tratados con fluconazol. La tasa de mortalidad a los 30 días fue del 56 %; los pacientes que no recibieron tratamiento y los que lo iniciaron más tarde tuvieron menor supervivencia (p<0,0001). MALDI-TOF/MS pudo identificar especies poco comunes de Candida spp. La enfermedad tuvo una alta mortalidad; la identificación correcta de las especies involucradas y la instauración de una terapia adecuada y oportuna son fundamentales para aumentar la supervivencia de los pacientes.
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