{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T18:03:08Z","timestamp":1784916188837,"version":"3.55.0"},"reference-count":50,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"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":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Candida<\/jats:italic>\n                      spp. infections are an increasing challenge in high-complexity hospitals, yet epidemiological data remain scarce in underrepresented in Colombian regions such as Tolima.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective observational study in a high-complexity hospital in Ibagu\u00e9 (Tolima, Colombia) from 2014 to 2024, integrating two institutional data sources: administrative\/clinical records and the microbiology laboratory database (WHONET). Species identification relied on culture and VITEK, and antifungal susceptibility was interpreted using criteria from the Clinical and Laboratory Standards Institute (CLSI) and the European Committee on Antimicrobial Susceptibility Testing (EUCAST). We summarized data using frequencies\/proportions and medians (IQR), explored patterns with multiple correspondence analysis (MCA), and estimated associations with candidemia using penalized multivariable logistic regression due to low event frequency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We identified 987 candidiasis episodes and 776 fungal isolates, of which 314 were\n                      <jats:italic>Candida<\/jats:italic>\n                      (40.46%). Mucocutaneous disease predominated (vulvovaginal 50.7%; oropharyngeal 24.3%), while candidemia represented 2.0% of episodes. Among isolates,\n                      <jats:italic>Candida albicans<\/jats:italic>\n                      was most frequent (58.9%), followed by\n                      <jats:italic>C. parapsilosis<\/jats:italic>\n                      (16.6%),\n                      <jats:italic>C. tropicalis<\/jats:italic>\n                      (12.1%), and\n                      <jats:italic>Nakaseomyces glabratus<\/jats:italic>\n                      (6.4%);\n                      <jats:italic>Candida auris<\/jats:italic>\n                      was detected once. In exploratory clinical\/administrative models, clinically recorded candidemia showed associations with invasive devices (OR 5.54, 95% CI 2.01\u201315.64), recent surgery (OR 7.11, 95% CI 1.20\u201330.88) and tumor (OR 19.88, 95% CI 3.14\u201397.51). Susceptibility data were available for 196\/314 isolates (62.4%); echinocandin activity was high, whereas azole susceptibility was more variable.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Candidiasis showed a sustained recorded burden and substantial non-\n                      <jats:italic>albicans<\/jats:italic>\n                      diversity, supporting local surveillance, species-level identification, and isolate-level susceptibility testing.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0354684","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T17:44:40Z","timestamp":1784915080000},"page":"e0354684","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical and microbiological epidemiology of Candida infections in a high-complexity hospital in Tolima, Colombia (2014\u20132024)"],"prefix":"10.1371","volume":"21","author":[{"given":"Rafael A.","family":"Ram\u00edrez-Trujillo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Carvajal-Hern\u00e1ndez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7052-7938","authenticated-orcid":true,"given":"\u00c1ngel","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"issue":"1","key":"pone.0354684.ref001","doi-asserted-by":"crossref","first-page":"1","DOI":"10.7705\/biomedica.4400","article-title":"Candidemia en Colombia","volume":"40","author":"J Cort\u00e9s","year":"2020","journal-title":"Biom\u00e9dica"},{"key":"pone.0354684.ref002","doi-asserted-by":"crossref","first-page":"11","DOI":"10.7705\/biomedica.7214","article-title":"Las infecciones f\u00fangicas: una amenaza creciente","volume":"43","author":"BL G\u00f3mez","year":"2023","journal-title":"Biomedica"},{"key":"pone.0354684.ref003","doi-asserted-by":"crossref","first-page":"18026","DOI":"10.1038\/nrdp.2018.26","article-title":"Invasive candidiasis","volume":"4","author":"PG Pappas","year":"2018","journal-title":"Nat Rev Dis Primers"},{"issue":"3","key":"pone.0354684.ref004","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.riam.2010.04.001","article-title":"Sensibilidad a fluconazol y voriconazol de especies de Candida aisladas de pacientes provenientes de unidades de cuidados intensivos en Medell\u00edn, Colombia (2001\u20132007)","volume":"27","author":"A Zuluaga","year":"2010","journal-title":"Rev Iberoam Micol"},{"issue":"3","key":"pone.0354684.ref005","doi-asserted-by":"crossref","first-page":"67","DOI":"10.3390\/jof5030067","article-title":"Emerging Fungal Infections: New Patients, New Patterns, and New Pathogens","volume":"5","author":"DZP Friedman","year":"2019","journal-title":"J Fungi (Basel)"},{"issue":"3","key":"pone.0354684.ref006","first-page":"2085","article-title":"Infecciones f\u00fangicas de afectaci\u00f3n cut\u00e1nea y superficial","volume":"8","author":"GA Barcia","year":"2022","journal-title":"Dominio de las Ciencias"},{"key":"pone.0354684.ref007","article-title":"Lineamientos nacionales para la vigilancia en salud p\u00fablica 2025 (vigilancia basada en eventos predefinidos). 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