<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0001-6002</journal-id>
<journal-title><![CDATA[Acta Médica Costarricense]]></journal-title>
<abbrev-journal-title><![CDATA[Acta méd. costarric]]></abbrev-journal-title>
<issn>0001-6002</issn>
<publisher>
<publisher-name><![CDATA[Colegio de Médicos y Cirujanos de Costa Rica]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0001-60022016000100015</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Epidemiología de la candidemia en el Hospital México]]></article-title>
<article-title xml:lang="en"><![CDATA[Candidemia and it&#8217;s Epidemiology at Hospital México]]></article-title>
<article-title xml:lang="en"><![CDATA[Candidemia and it&#8217;s Epidemiology at Hospital México]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Villalobos-Vindas]]></surname>
<given-names><![CDATA[Juan Manuel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Castro-Cordero]]></surname>
<given-names><![CDATA[José Antonio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Avilés-Montoya]]></surname>
<given-names><![CDATA[Álvaro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Peláez-Gil]]></surname>
<given-names><![CDATA[María Claudia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Somogyi-Pérez]]></surname>
<given-names><![CDATA[Teresita]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sandoval-Carpio]]></surname>
<given-names><![CDATA[Lilliana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,CCSS Hospital México Servicio de Infectología]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af2">
<institution><![CDATA[,CCSS Dirección Farmacoepidemiología ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af3">
<institution><![CDATA[,CCSS Laboratorio Clínico, Hospital México División de Bacteriología]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>03</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>03</month>
<year>2016</year>
</pub-date>
<volume>58</volume>
<numero>1</numero>
<fpage>15</fpage>
<lpage>21</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S0001-60022016000100015&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S0001-60022016000100015&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S0001-60022016000100015&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Justificación y objetivos: Las infecciones invasivas por Candida son frecuentes y de alta mortalidad en la práctica clínica. Existe poca información publicada al respecto en el país. Estudio retrospectivo y observacional que pretende aportar conocimiento novedoso sobre la epidemiología local de la candidemia.  Métodos: Se incluyó 136 pacientes mayores de 17 años en su primer episodio de candidemia, internados en el Hospital México, entre 2007 y 2010. Se realizó un análisis descriptivo y temporal, se evaluaron los factores asociados con C. parapsilosis y con la sobrevida a 30 días.  Resultados: Se detectó en promedio 34 episodios por año (rango 27 a 51), la incidencia acumulada fue de 1,1 casos/1000 admisiones. Las especies de Candida no albicans constituyeron el 62% de las levaduras aisladas. Exceptuando 2009, C. parapsilosis fue la especie predominante en 3 de 4 años estudiados (41%), seguida por C. albicans (38%). Se demostró una fuerte asociación entre la candidemia por C. parapsilosis, la presencia de catéter venoso central (OR=19,6, IC95%: 2,6 a 403,8, p&lt;0,001) y el uso de nutrición parenteral (p=0,014). La mortalidad a 30 días fue del 46%. C. albicans mostró la mortalidad más alta y C. parapsilosis, la más baja. Los pacientes que no recibieron tratamiento antifúngico presentaron una probabilidad significativamente mayor de morir.  Conclusiones: La elevada incidencia de candidemia por C. parapsilosis está directamente relacionada con los catéteres venosos centrales y el uso de nutrición parenteral; su marcada reducción en la frecuencia durante 2009, merece ser investigada para dilucidar los factores que provocaron este cambio.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Background: Invasive Candida infections are frequent and exhibit high mortality in clinical practice. There are few published data in our country. This retrospective observational study intends to provide new knowledge about the local epidemiology of candidemia.  Methods: 136 patients older than 17 years were included when they had their first episode of candidemia during hospitalization at the Hospital Mexico, in the time period between 2007 and 2010. Descriptive and temporal analysis was performed and the risk factors associated with C. parapsilosis and survival were evaluated.  Results: An average of 34 episodes of candidemia were recorded per year (range 27-51) and the cumulative incidence was 1.1 cases/1,000 admissions. The non-albicans Candida species accounted for 62% of the isolated yeasts, C. parapsilosis (41%) was the predominant yeast isolated in 3 out of the 4 years analized, except for 2009, followed by C. albicans (38%). Strong association between C. parapsilosis bloodstream infection, the presence of a central venous catheter (2.6 to 403.8, p &lt;0.001 OR = 19.6, 95% CI) and use of parenteral nutrition (p=0.014) was established. The 30-day mortality was 46%, with C. albicans displaying the highest and C. parapsilosis the lowest. Patients who did not receive antifungal treatment had significantly higher mortality.  Conclusions: The unusually high incidence of candidemia due to C. parapsilosis is directly related to the use of central venous catheters and parenteral nutrition; the marked reduction observed in 2009 needs further investigation to find out the causes of this change.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Candida parapsilosis]]></kwd>
<kwd lng="es"><![CDATA[candidemia]]></kwd>
<kwd lng="es"><![CDATA[fungemia]]></kwd>
<kwd lng="es"><![CDATA[sepsis]]></kwd>
<kwd lng="es"><![CDATA[síndrome de respuesta inflamatoria sistémica]]></kwd>
<kwd lng="en"><![CDATA[Candida parapsilosis]]></kwd>
<kwd lng="en"><![CDATA[candidemia]]></kwd>
<kwd lng="en"><![CDATA[fungemia]]></kwd>
<kwd lng="en"><![CDATA[sepsis]]></kwd>
<kwd lng="en"><![CDATA[systemic inflammatory response syndrome.]]></kwd>
</kwd-group>
</article-meta>
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<article-title xml:lang=""><![CDATA[Timing of susceptibility-based antifungal drug administration in patients with Candida bloodstream infection: correlation with outcomes]]></article-title>
<source><![CDATA[J Antimicrob Chemother]]></source>
<year>2012</year>
<volume>67</volume>
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</article>
