Comparative Study of Invasive Candidiasis in Mexico and Spain
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Candida genus includes more than 150 species, including some human pathogens such as Candida albicans, Candida guilliermondii, Candida krusei, Candida parapsilosis, Candida tropicalis, Candida lusitaniae, Candida dubliniensis and Candida glabrata. These fungi are found in non-living objects, food, animals and some of them are part of the human microbiota (mycobiota) without causing disease. Gastrointestinal tract (including oral cavity and pharynx), female genitals and skin are common environments for Candida. Since the introduction of antifungal drugs, the aetiology of invasive candidiasis is a changing from a complete predominance of C. albicans to a more diverse participation from other species, such as C. glabrata or C. parapsilosis (Longo, Fauci, Kasper & Hauser, 2012).
Invasive candidiasis is the most common fungal disease in hospitalized patients. This disease comprises different clinical presentation such as candidemia or different organ or deep tissue infections. Candidemia is the most common presentation. Deep candidiasis is caused by bloodstream dissemination or direct inoculation of the fungus in organs and tissues. Mortality among patients with invasive candidiasis is high (15-40%) (del Palacio, Villar & Alhambra, 2009) even when the patients have been treated with antifungal therapy. This growing incidence from the non-albicans species is worrying because many species are resistant to current antifungal drugs (Kullberg & Arendrup, 2015).
Methods: A systematic bibliographical review was realized, so we could identify and resume all publications related to invasive candidiasis, its clinical characteristics and epidemiology. A relevant article selection was performed, we were guided by title, abstract and the ones that were what we expected were meticulously read and reviewed. National Library of Medicine, Pub-Med search engine was used and papers from 2009 to 2017 were selected. The keywords used are as follows: “Candida”, “Candida and Mexico”, “Candida and Spain”, “Invasive candidiasis”, “Candidemia”, “Candida and Epidemiology” and “Candida and Children”. Finally, a report was made with the most prominent findings.
Conclusion: In Mexico, candidemia in paediatric patients is caused by C. albicans (64%), followed by C. tropicalis (26%), C. glabrata (6%) and C. parapsilosis (2%) (Martínez Garnica, Jiménez Jiménez, Ramírez Guerrero & López Martínez, 2015). In adult patients, C. albicans (62%), followed by C. glabrata (12%), C. tropicalis (7.5%), C. parapsilosis (7.3%), and C. krusei (2.7%) are the most frequently isolated (del Palacio, Villar & Alhambra, 2009).
Spanish paediatric candidiasis are mostly caused by C. parapsilosis (43%), followed by C. albicans (36%). The rest of infections are mainly caused by C. glabrata, C. tropicalis and C. krusei (García-Rodríguez et al., 2013). C. albicans is the fungus most isolated in Spanish adult patients (40-75%), followed by C. glabrata or C. parapsilosis (25%) according to differences in geographical areas, C. tropicalis (10%) and less frequently C. krusei, C. lusitaniae and C. guilliermondii (Gómez, García Vázquez, Hernández, Espinoza & Ruiz, 2010).
Besides the bibliographical review and the writing of an extended written essay, I have been working at the Microbiology laboratory, helping to the realization of several laboratory activities that would help to accomplish the Master Thesis named “Capacidad de desinfección de un aparato de luz ultravioleta y comparación con otros desinfectantes y antisépticos”.
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del Palacio, A., Villar, J., & Alhambra, A. (2009). Epidemiología de las candidiasis invasoras en población pediátrica y adulta. Revista Iberoamericana De Micología, 26(1), 2-7. http://dx.doi.org/10.1016/s1130-1406(09)70002-6
García-Rodríguez, J., Cantón, E., Pemán, J., Alvarez, M., Ezpeleta, G., & Gómez-Nieto, A. et al. (2013). Incidencia etaria y geográfica y patrón de sensibilidad a los antifúngicos de las especies de Candida causantes de candidemia en la población pediátrica española. Enfermedades Infecciosas Y Microbiología Clínica, 31(6), 363-368. http://dx.doi.org/10.1016/j.eimc.2012.09.018
Gómez, J., García Vázquez, E., Hernández, A., Espinoza, C., & Ruiz, J. (2010). Candidemias nosocomiales: nuevos retos de un problema emergente. Revista Española De Quimioterapia, 23(4), 158-169.
Kullberg, B., & Arendrup, M. (2015). Invasive Candidiasis. New England Journal Of Medicine, 373(15), 1445-1456. http://dx.doi.org/10.1056/nejmra1315399
Longo, D., Fauci, A., Kasper, D., & Hauser, S. (2012). Harrison. Principios de Medicina Interna (12th ed.). México: McGraw-Hill Interamericana.