Candidaemia due to "Candida parapsilosis" species complex at a hospital in Brazil: Clinical characteristics and antifungal susceptibility profile

Abstract Background Recent decades have seen a global emergence of candidaemia caused by non- Candida albicans Candida species, particularly the Candida parapsilosis complex. Aims To evaluate the clinical features and antifungal susceptibility profiles of isolates belonging to the C. parapsilosis species complex in patients with candidaemia in a midwestern Brazilian tertiary-care teaching hospital. Methods Yeast identification was performed using an automated Vitek 2 Compact system. PCR-RFLP was employed for species differentiation. Results Five cases of infection by C. parapsilosis sensu stricto and two by Candida orthopsilosis were found. Of the seven cases, five were adult patients undergoing haemodialysis. The only isolate of C. parapsilosis sensu stricto resistant to fluconazole (MIC = 8 μg/ml) was obtained from a patient on a long-term regimen with this drug. This was the only patient who evolved to death. Conclusions Resistance to antifungal agents poses a therapeutic challenge, especially for non- C . albicans Candida species, and requires continuous monitoring using susceptibility tests because resistance in vitro can be predictive of treatment failure. In the present study, in vitro antifungal susceptibility proved consistent with clinical outcome.