Brazilian Journal of Microbiology (2009) 40:325-328 ISSN 1517-8382 325 CANDIDA ISOLATES IN TERTIARY HOSPITALS IN NORTHEASTERN BRAZIL Sylvia Lemos Hinrichsen 1 *; Érica Falcão 2 ; Tatiana Aguiar Santos Vilella 1 ; Leandro Rêgo 3 ; Conceição Lira 1 ; Luciano Almeida 2 ; Mízia Martins 2 ; Carmem Araújo 2 ; Marcelo Duarte 2 ; Geraldo Lopes 2 1 Núcleo de Ensino, Pesquisa e Assistência em Infectologia, Universidade Federal de Pernambuco, Recife, PE, Brasil; 2 Cerpe Diagnósticos, Recife, PE, Brasil; 3 Departamento de Estatística, Universidade Federal de Pernambuco, Recife, PE, Brasil. Submitted: March 27, 2008; Returned to authors for corrections: July 01, 2008; Approved: February 25, 2009. ABSTRACT Candida is an opportunistic pathogen that affects high–risk patients who are either immunocompromised or critically ill and is associated with almost 80% of all nosocomial fungal infections, representing the major cause of fungemia with high mortality rates (40%). Candida albicans is the main cause of candidemia and among the non-albicans species C. parapsilosis, C. glabrata and C. tropicalis are the most frequent agents. The aim of this study was to evaluate the distribution of Candida species in two tertiary hospitals in Recife, Northeastern Brazil. It began by surveying all positive Candida cultures processed by the microbiology laboratory from September 2003 to September 2006. The cultures, originated from various types of biological material (blood, urine, tracheal, catheter and others), were processed by Vitec ® system (Biomerieux SA, France). A total of 1.279 (hospital A: 837; hospital B: 442) sample isolates were positive for Candida. The most frequent species in both hospitals were: C. albicans (367), C. tropicalis (363), C. parapsilosis (147), C. glabrata (81), C. krusei (30) and C. guillermondii (14). The isolates were obtained from 746 hospitalized patients. A total of 221 positive hemocultures were detected in 166 different patients in both hospitals, and 113 (68.1%) of these patients with positive hemocultures presented Candida in other body sites. This study shows that Candida non-albicans was the main isolated agent and evidences the importante of C. tropicalis in nosocomial fungal infections. Key words: Candida, candidemia, candida isolates. *Corresponding Author. Mailing address: Rua Jornalista Guerra de Holanda, 158/2601. CEP 52061-010. Casa Forte, Recife, PE, Brasil.; Phone/Fax: 81 3268-9905. E-mail: sylviahinrichsen@hotmail.com Candida is an opportunistic pathogen that affects high- risk patients who are either immunocompromised or critically ill (4,6,14,15). Throughout the 1990s, the incidence of invasive fungal infections such candidiasis increased significantly worldwide, a concern because invasive fungal infections which are also difficult to diagnose, prevent, and treat (7,14,15,17). Candida is associated with almost 80% of all nosocomial fungal infections, representing the major cause of fungemia with high mortality rates (40%) (4,6,8,14). Candida albicans is the main cause of candidemia and among the non-albicans species C. parapsilosis, C. glabrata and C. tropicalis are the most frequent agents (4,6,7,14,18). Studies have demonstrated direct association between the number of body sities colonized and the incidence of candidiasis. Cultures are positive in only 50% of patients with invasive candidiasis, and diagnosis is confirmed ant mortens in only 15 to 40% of cases (4,6,7,14,15,18,19,23). The aim of this study is to evaluate the distribution of Candida species in tertiary hospitals in Northeastern Brazil. This observational prospective study was performed at two tertiary private hospitals (hospital A: 217 beds; hospital B: 54 beds) in Recife, Pernambuco state, northeastern, Brazil. It began by surveying all positive Candida cultures processed by the microbiology laboratory from September 2003 to September 2006. A database was created with the following