{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T14:50:19Z","timestamp":1791557419227,"version":"4.3.4"},"reference-count":42,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2019,3,8]],"date-time":"2019-03-08T00:00:00Z","timestamp":1552003200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Background<\/jats:title>\n Active surveillance is necessary for improving the management and outcome of patients with candidemia. The aim of this study was to describe epidemiologic and clinical features of candidemia in children and adults in tertiary level hospitals in Chile.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We conducted a prospective, multicenter, laboratory-based survey study of candidemia in 26 tertiary care hospitals in Chile, from January 2013 to October 2017.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 780 episodes of candidemia were included, with a median incidence of 0.47\/1,000 admissions. Demographic, clinical and microbiological information of 384 cases of candidemia, from 18 hospitals (7,416 beds), was included in this report. One hundred and thirty-four episodes (35%) occurred in pediatric patients and 250 (65%) in adult population.\n Candida albicans<\/jats:italic>\n (39%),\n Candida parapsilosis<\/jats:italic>\n (30%) and\n Candida glabrata<\/jats:italic>\n (10%) were the leading species, with a significant difference in the distribution of species between ages. The use of central venous catheter and antibiotics were the most frequent risk factors in all age groups (> 70%). Three hundred and fifteen strains were studied for antifungal susceptibility; 21 strains (6.6%) were resistant to fluconazole, itraconazole, voriconazole, anidulafungin or micafungin. The most commonly used antifungal therapies were fluconazole (39%) and echinocandins (36%). The overall 30-day survival was 74.2%, significantly higher in infants (82%) and children (86%) compared with neonates (72%), adults (71%) and elderly (70%).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Our prospective, multicenter surveillance study showed a low incidence of candidemia in Chile, with high 30-day survival, a large proportion of elderly patients,\n C<\/jats:italic>\n .\n glabrata<\/jats:italic>\n as the third most commonly identified strain, a 6.6% resistance to antifungal agents and a frequent use of echinocandins.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0212924","type":"journal-article","created":{"date-parts":[[2019,3,8]],"date-time":"2019-03-08T13:27:17Z","timestamp":1552051637000},"page":"e0212924","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":37,"title":["A prospective, multi-center study of Candida bloodstream infections in Chile"],"prefix":"10.1371","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0879-002X","authenticated-orcid":true,"given":"Maria E.","family":"Santolaya","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Thompson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dona","family":"Benadof","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Tapia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulette","family":"Legarraga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Cort\u00e9s","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcela","family":"Rabello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romina","family":"Valenzuela","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Rojas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Rabagliati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the Chilean Invasive Mycosis Network","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2019,3,8]]},"reference":[{"key":"pone.0212924.ref001","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.1128\/JCM.43.4.1829-1835.2005","article-title":"Epidemiology and predictors of mortality in cases of Candida blood- stream infection: results from population-based surveillance, Barcelona, Spain, from 2002 to 2003","volume":"43","author":"B Almirante","year":"2005","journal-title":"J. Clin. Microbiol"},{"key":"pone.0212924.ref002","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4161\/viru.26187","article-title":"Invasive candidiasis as a cause of sepsis in the critically ill patient","volume":"5","author":"J Delaloye","year":"2014","journal-title":"Virulence"},{"key":"pone.0212924.ref003","doi-asserted-by":"crossref","first-page":"1252","DOI":"10.1097\/INF.0b013e3182737427","article-title":"Results from a prospective, international, epidemiologic study of invasive candidiasis in children and neonates","volume":"31","author":"WJ Steimbach","year":"2012","journal-title":"Pediatric Infect Dis J"},{"key":"pone.0212924.ref004","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.1007\/s00134-014-3400-y","article-title":"Prognostic factors and historical trends in the epidemiology of candidemia in critically ill patients: an analysis of ve multicenter centers sequentially conducted over a 9-year period","volume":"40","author":"A L Colombo","year":"2014","journal-title":"Intensive Care Med"},{"key":"pone.0212924.ref005","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1007\/s00134-014-3310-z","article-title":"A multicenter study of septic shock due to candidemia: outcomes and predictors of mortality","volume":"40","author":"M Bassetti","year":"2014","journal-title":"Intensive Care Med"},{"key":"pone.0212924.ref006","first-page":"1198","article-title":"Emerging infections program healthcare-associated infections and antimicrobial use prevalence survey team. 2014 Multistate point-prevalence survey of health care-associated infections","volume":"370","author":"SS Magill","journal-title":"N Engl J Med"},{"key":"pone.0212924.ref007","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1007\/s10096-007-0270-z","article-title":"Multicenter retrospective development and validation of a clinical prediction rule for nosocomial invasive candidiasis in the intensive care setting","volume":"26","author":"L Ostrosky-Zeichner","year":"2007","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"pone.0212924.ref008","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0154944","article-title":"The Effect of Inadequate Initial Empiric Antimicrobial Treatment on Mortality in Critically Ill Patients with Bloodstream Infections: A Multi-Centre Retrospective Cohort Study","volume":"11","author":"RD Savage","year":"2016","journal-title":"PLoS One"},{"key":"pone.0212924.ref009","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1086\/421946","article-title":"Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study","volume":"39","author":"H Wisplinghoff","year":"2004","journal-title":"Clin Infect Dis"},{"key":"pone.0212924.ref010","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/j.ijantimicag.2006.01.002","article-title":"Candidaemia in Europe: epidemiology and resistance","volume":"27","author":"AM Tortorano","year":"2006","journal-title":"Int J Antimicrob Agents"},{"key":"pone.0212924.ref011","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1086\/421946","article-title":"Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study","volume":"39","author":"H Wisplinghoff","year":"2004","journal-title":"Clin. Infect. Dis"},{"key":"pone.0212924.ref012","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1086\/380637","article-title":"Epidemiology of candidaemia in Swiss tertiary care hospitals: secular trends, 1991\u20132000","volume":"38","author":"O Marchetti","year":"2004","journal-title":"Clin. Infect. Dis"},{"key":"pone.0212924.ref013","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1007\/s11046-018-0258-5","article-title":"Candidemia in adults at a tertiary Hospital in China: Clinical characteristics, Species distribution, Resistence and outcome","volume":"183","author":"S Lin","year":"2018","journal-title":"Mycopathologia"},{"issue":"10","key":"pone.0212924.ref014","article-title":"Epidemiology and antifungal susceptibility of candidemia isolates of non-albicans Candida species from cancer patients","volume":"6","author":"PF Wu","year":"2017","journal-title":"Emerg Microbes Infect"},{"key":"pone.0212924.ref015","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1093\/jac\/dkx047","article-title":"Changing epidemiology of candidemia in Australia","volume":"72","author":"B Chapman","year":"2017","journal-title":"J Antimicrob Chemother"},{"issue":"3","key":"pone.0212924.ref016","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0059373","article-title":"Epidemiology of candidemia in Latin America: a laboratory-based survey","volume":"8","author":"M Nucci","year":"2013","journal-title":"PlosOne"},{"key":"pone.0212924.ref017","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1097\/INF.0000000000000039","article-title":"Active surveillance of candidemia in children from Latin America: a key requirement for improving disease outcome","volume":"33","author":"ME Santolaya","year":"2014","journal-title":"Pediatr Infect Dis J"},{"issue":"4","key":"pone.0212924.ref018","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0175172","article-title":"A multi-centric Study of Candida bloodstream infection in Lima-Callao, Peru: Species distribution, antifungal resistance and clinical outcomes","volume":"12","author":"L Rodriguez","year":"2017","journal-title":"PLoS One"},{"key":"pone.0212924.ref019","doi-asserted-by":"crossref","first-page":"2816","DOI":"10.1128\/JCM.00773-06","article-title":"Epidemiology of Candidemia in Brazil: a Nationwide Sentinel Surveillance of Candidemia in Eleven Medical Centers","volume":"44","author":"AL Colombo","year":"2006","journal-title":"J Clin Microbiol"},{"issue":"5","key":"pone.0212924.ref020","article-title":"Surveillance of Candida spp Bloodstream Infections: Epidemiological Trends and Risk Factors of Death in Two Mexican Tertiary Care Hospitals","volume":"9","author":"DE Corzo-Leon","year":"2014","journal-title":"PLoS One"},{"issue":"1","key":"pone.0212924.ref021","article-title":"Epidemiology and Microbiologic Characterization of Nosocomial Candidemia from a Brazilian National Surveillance Program","volume":"11","author":"AM Doi","year":"2016","journal-title":"PLoS One"},{"key":"pone.0212924.ref022","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1007\/s10096-017-2925-8","article-title":"Serious fungal infections in Chile","volume":"36","author":"E Alvarez Duarte","year":"2017","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"pone.0212924.ref023","first-page":"19","article-title":"Clinical and epidemiological changes of candidemia among adult patients from 2000 to 2013","volume":"34","author":"L Siri","year":"2017","journal-title":"Rev Chilena Infectol"},{"key":"pone.0212924.ref024","unstructured":"Clinical and Laboratory Standards Institute. Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeast; Fourth Informational Supplement. M27-S4; December 2012"},{"issue":"2","key":"pone.0212924.ref025","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.riam.2016.04.001","article-title":"The role of epidemiological cutoff values (ECVs\/ECOFFs) in antifungal susceptibility testing and interpretation for uncommon yeasts and moulds","volume":"33","author":"A Espinel-Ingroff","year":"2016","journal-title":"Rev Iber Micol"},{"key":"pone.0212924.ref026","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/j.ijantimicag.2017.05.019","article-title":"Epidemiology of antifungal resistance in human pathogenic yeasts: current viewpoint and practical recommendations for management","volume":"50","author":"D Farmakiotis","year":"2017","journal-title":"International J. Antimicrob Agents"},{"issue":"10","key":"pone.0212924.ref027","doi-asserted-by":"crossref","first-page":"1508","DOI":"10.3201\/eid1210.060389","article-title":"Active Surveillance of Candidemia, Australia","volume":"12","year":"2006","journal-title":"Emerg Infect Dis"},{"key":"pone.0212924.ref028","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1007\/s10096-016-2841-3","article-title":"Epidemiology and reporting of candidaemia in Belgium: a multi-centre study","volume":"36","author":"C Trouve","year":"2017","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"pone.0212924.ref029","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1016\/j.eimc.2010.12.003","article-title":"Candidemias: multicentre analysis in 16 hospitals in Andalusia (Spain)","volume":"29","author":"MJ Rodriguez-Hernandez","year":"2011","journal-title":"Enferm Infecc Microbiol Clin"},{"key":"pone.0212924.ref030","article-title":"The epidemiology and management of candidemia in Northern Ireland during 2002\u22122011, including a 12-month enhanced case review","author":"R Spiers","year":"2018","journal-title":"Med Mycol"},{"key":"pone.0212924.ref031","article-title":"Epidemiology, Species Distribution, Antifungal Susceptibility and Outcome of Nosocomial Candidemia in a Tertiary Care Hospital in Italy","volume":"6","author":"M Basseti","year":"2011","journal-title":"Plos One"},{"key":"pone.0212924.ref032","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1111\/myc.12535","article-title":"Differences in epidemiology of candidaemia in the Nordic countries\u2014what is to blame?","volume":"60","author":"L Hesstvedt","year":"2017","journal-title":"Mycoses"},{"key":"pone.0212924.ref033","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1111\/1469-0691.12440","article-title":"Candida species distribution and antifungal susceptibility testing according to European Committee on Antimicrobial Susceptibility Testing and new vs. old Clinical and Laboratory Standards Institute clinical breakpoints: a 6-year prospective candidaemia survey from the fungal infection network of Switzerland","volume":"20","author":"C Orasch","year":"2014","journal-title":"Clin Microbiol Infect"},{"key":"pone.0212924.ref034","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1086\/599039","article-title":"Epidemiology and Outcomes of Candidemia in 2019 Patients: Data from the Prospective Antifungal Therapy Alliance Registry","volume":"48","author":"DL Horn","year":"2009","journal-title":"Clin Infect Dis"},{"issue":"10","key":"pone.0212924.ref035","doi-asserted-by":"crossref","DOI":"10.1128\/AAC.00906-17","article-title":"Monitoring Antifungal Resistance in a Global Collection of Invasive Yeasts and Molds: Application of CLSI Epidemiological Cutoff Values and Whole Genome Sequencing Analysis for Detection of Azole Resistance in Candida albicans","volume":"61","author":"M Castanheira","year":"2017","journal-title":"Antimicrob Agents Chemother"},{"issue":"5","key":"pone.0212924.ref036","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1111\/ajt.13186","article-title":"Emerging issues with diagnosis and management of fungal infections in solid organ transplant recipients","volume":"15","author":"D Farmakiotis","year":"2015","journal-title":"Am J Transplant"},{"key":"pone.0212924.ref037","article-title":"Repeated antifungal use audits are essential for selecting the targets for intervention in antifungal stewardship","author":"M Valerio","year":"2018","journal-title":"Eur J Clin Microbiol"},{"key":"pone.0212924.ref038","article-title":"Impact of an antifungal stewardship programme in a tertiary respiratory medicine setting: A prospective real-world study","author":"L Nwanko","year":"2018","journal-title":"Antimicrob Agents Chemother"},{"key":"pone.0212924.ref039","doi-asserted-by":"crossref","DOI":"10.1093\/cid\/civ1194","article-title":"Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America","volume":"62","author":"PG Pappas","year":"2016","journal-title":"Clin Infect Dis"},{"key":"pone.0212924.ref040","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.riam.2013.05.007","article-title":"Recommendations for the management of candidemia in adults in Latin America. Grupo Proyecto \u00c9pico","volume":"30","author":"M Nucci","year":"2013","journal-title":"Rev Iberoam Micol"},{"key":"pone.0212924.ref041","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.riam.2013.05.010","article-title":"Recommendations for the management of candidemia in children in Latin America. Grupo Proyecto \u00c9pico","volume":"30","author":"ME Santolaya","year":"2013","journal-title":"Rev Iberoam Micol"},{"key":"pone.0212924.ref042","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.riam.2013.05.012","article-title":"Recommendations for the management of candidemia in neonates in Latin America. Grupo Proyecto \u00c9pico","volume":"30","author":"ME Santolaya","year":"2013","journal-title":"Rev Iberoam Micol"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0212924","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T14:03:06Z","timestamp":1791554586000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0212924"}},"subtitle":[],"editor":[{"given":"Alix Therese","family":"Coste","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2019,3,8]]},"references-count":42,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2019,3,8]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0212924","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3,8]]}}}