High rate of non-albicans candidemia in Brazilian tertiary care hospitals

In order to evaluate the epidemiology of candidemia in Brazil, we performed a prospective multicenter study conducted in six general hospitals from Sa o Paulo and Rio de Janeiro. We enrolled a total of 145 candidemic patients (85 males) with a median age of 32 years. Non-albicans species accounted fo r 63% of all episodes and the species most frequently causing candidemia we re C. albicans (37%), C. parapsilosis (25%), C. tropicalis (24%), C. rugosa (5%), and C. glabrata (4%). Systemic azoles were used before the onset of candidemia in only six patients. There were no differences in the coexistin g exposures or underlying diseases associated with the species most frequen tly causing candidemia. The overall crude mortality rate was 50%. Nosocomia l candidemias in our tertiary hospitals are caused predominantly by non-alb icans species, which are rarely fluconazole resistant. This predominance of non-albicans species could not be related to the previous use of azoles. ( C) 1999 Elsevier Science Inc.