Infecciones asociadas a la atención sanitaria causadas por Candida spp. en neonatos críticos: un análisis de las superficies ambientales
DOI:
https://doi.org/10.17058/reci.v14i4.19358Palabras clave:
Infecciones Fúngicas Invasoras, Infección Hospitalaria, Control de Infecciones, Salud del LactanteResumen
Justificación y Objetivos: las infecciones fúngicas invasivas conllevan altas tasas de morbilidad y mortalidad en las Unidades de Cuidados Intensivos Neonatales (UCINs) y están acompañadas por un aumento en la prevalencia de aislamientos resistentes, destacando el ambiente hospitalario como la principal fuente de contaminación. Este estudio identificado las especies de Candida en neonatos en una UCIN brasileña, evaluó sus condiciones clínicas y de laboratorio y caracterizó los aislamientos. Métodos: se identificaron y analizaron los aislamientos de Candida de recién nacidos (RNs) y del ambiente en relación con la resistencia antifúngica, los factores de virulencia y las relaciones moleculares. Resultados: cuatro RNs presentaron candidiasis invasiva, como C. albicans (2 RNs), C. glabrata (1 RN) y C. parapsilosis sensu stricto (1 RN). Todos los RNs eran extremadamente prematuros (<29 semanas) y habían utilizado al menos un dispositivo invasivo. Dos aislamientos clínicos demostraron resistencia, uno al fluconazol (C. parapsilosissensu stricto) y el otro a la micafungina (C. glabrata). Cinco aislamientos ambientales se identificaron como C. parapsilosis sensu stricto, y uno de ellos mostró susceptibilidad dependiente de la dosis al fluconazol. El biofilm fue el único factor de virulencia producido por los nueve aislamientos. El análisis molecular reveló una alta similitud entre un aislamiento ambiental y uno clínico de C. parapsilosis sensu stricto. Conclusión: los resultados indicaron la presencia de especies de Candida en neonatos y en el ambiente de la UCIN, con algunas mostrando resistencia in vitro al fluconazol y a la micafungina. Todos los aislamientos produjeron biofilm. Se observó una notable similitud genética entre algunos aislamientos ambientales y clínicos, lo que sugiere que el ambiente podría ser una posible fuente de infección.
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Derechos de autor 2025 Priscila Guerino Vilela, Isadora Caixeta da Silveira Ferreira, Ralciane de Paula Menezes, Mário Paulo Amante Penatti, Reginaldo dos Santos Pedroso, Denise Von Dolinger de Brito Röder
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