Casos de Candidemia no Brasil, entre os anos de 2018 a 2021: uma revisão narrativa.

Abstract

Candida is a genus composed of yeasts that are part of the normal human microbiota. However, when there is an immunological imbalance, opportunistic infections can occur in the host, such as candidemias. The present study aimed to investigate the landscape of candidemia in Brazil from 2018 to 2021. To achieve this, the PubMed, ScienceDirect, Scielo, BVS, and CAPES journal databases were utilized, employing the descriptors "candidemia in Brazil," "systemic Candida infection," "nosocomial candidiasis," and "candidemia." A total of 756 papers were identified in the search, from which 11 were selected for further analysis. The incidence data of candidemia ranged from 0.91 to 2.49 per 1,000 hospital admissions in Brazil. The majority of candidemia cases occurred in elderly patients, predominantly males. C. albicans was the most isolated species, although an increase in non-albicans species was noted. The most frequently used antifungal therapy was fluconazole (45.45%), despite the growing use of other drugs such as echinocandins (18.18%). Due to its prolonged and often empirical use, strains generally developed resistance to fluconazole (54.54%). A high mortality rate was observed, ranging from 48% in Paraná to 86.3% in Rio de Janeiro, particularly in patients with late diagnosis or those who did not use antifungals. The studies presented provide important results for establishing an epidemiological profile of candidemia through surveillance cultures and the creation of indicators to contribute to prevention and therapeutic protocols.