Systemic and localized infection by Candida species in patients with rheumatic diseases receiving anti-TNF therapy

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.author AIKAWA, Nadia E. FMUSP-HC
ROSA, Daniela T. A.
NEGRO, Gilda M. B. Del FMUSP-HC
MORAES, Julio C. B. FMUSP-HC
RIBEIRO, Ana C. M. FMUSP-HC
SAAD, Carla Goncalves FMUSP-HC
SILVA, Clovis A. FMUSP-HC
BONFA, Eloisa FMUSP-HC
dc.date.issued 2016
dc.identifier.citation REVISTA BRASILEIRA DE REUMATOLOGIA, v.56, n.6, p.478-482, 2016
dc.identifier.issn 0482-5004
dc.identifier.uri http://observatorio.fm.usp.br/handle/OPI/17971
dc.description.abstract Objective: To evaluate the prevalence of systemic and localized infection by Candida species and its possible association with demographic, clinical and laboratory manifestations and therapy in patients with rheumatic diseases taking TNF blockers. Methods: Consecutive patients with rheumatic diseases receiving anti-TNF agents were included. The following risk factors up to four weeks prior to the study were analyzed: use of antibiotics, immunosuppressant drugs, hospitalization and invasive procedures. All subjects were evaluated for clinical complaints; specific blood cultures were obtained for fungi and blood samples were collected for Candida spp. detection by polymerase chain reaction. Results: 194 patients [67 with rheumatoid arthritis (RA), 47 with ankylosing spondylitis (AS), 36 with juvenile idiopathic arthritis (JIA), 28 with psoriatic arthritis and 16 with other conditions] were included. The average age of patients was 42 +/- 16 years, with 68 (35%) male and mean disease duration of 15 +/- 10 years. Sixty-four (33%) patients were receiving adalimumab, 59 (30%) etanercept and 71 (36%) infliximab. Eighty-one percent of patients were concomitantly taking immunosuppressant drugs. At the time of the study, only one (0.5%) patient had localized fungal infection (vaginal candidiasis). None of the patients included had systemic candidiasis with positive blood cultures for fungi or IDCR positive for Candida spp. in peripheral blood sample. Conclusions: This was the first study to assess the prevalence of invasive and localized fungal disease by Candida in a significant number of patients with rheumatic diseases on anti-TNF therapy, and demonstrated low risk of candidiasis, despite the high prevalence of immunosuppressive drug use. (C) 2015 Elsevier Editora Ltda.
dc.description.sponsorship · Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [2009/51897-5]
· Conselho Nacional do Desenvolvimento Cientifico e Tecnologico (CNPq) [302724/2011-7, 301411/2009-3]
· Federico Foundation for CAS
· Nucleo de Apoio a Pesquisa ""Saude da Crianca e do Adolescente"", USP (NAP-CriAd)
dc.language.iso eng
dc.language.iso por
dc.publisher ELSEVIER SCIENCE INC
dc.relation.ispartof Revista Brasileira de Reumatologia
dc.rights openAccess
dc.subject Systemic candidiasis; Candida spp.; Anti-TNF; Rheumatoid arthritis; Ankylosing spondylitis
dc.subject.other necrosis-factor-alpha; polymerase chain-reaction; fungal-infections; arthritis; albicans; classification; infliximab; criteria; blood; risk
dc.title Systemic and localized infection by Candida species in patients with rheumatic diseases receiving anti-TNF therapy
dc.title.alternative Infecção sistêmica e localizada por Candida spp. em pacientes reumatológicos em terapia anti-TNF
dc.type article
dc.rights.holder Copyright ELSEVIER SCIENCE INC
dc.description.group LIM/53
dc.description.group LIM/17
dc.description.group LIM/36
dc.identifier.doi 10.1016/j.rbre.2015.08.004
dc.identifier.pmid 27914593
dc.type.category original article
dc.type.version publishedVersion
hcfmusp.author AIKAWA, Nadia E.:HC:ICHC
hcfmusp.author NEGRO, Gilda M. B. Del:HC:LIM/53
hcfmusp.author MORAES, Julio C. B.:HC:ICHC
hcfmusp.author RIBEIRO, Ana C. M.:HC:ICHC
hcfmusp.author SAAD, Carla Goncalves:HC:ICHC
hcfmusp.author SILVA, Clovis A.:FM:MPE
hcfmusp.author BONFA, Eloisa:FM:MCM
hcfmusp.author.external · ROSA, Daniela T. A.:Univ Sao Paulo, Fac Med, Lab Micol Med LIM 53, Sao Paulo, SP, Brazil; Inst Med Trop Sao Paulo, Sao Paulo, SP, Brazil
hcfmusp.origem.id 2-s2.0-85007368640
hcfmusp.origem.id WOS:000389548800003
hcfmusp.origem.id SCIELO:S0482-50042016000600478
hcfmusp.publisher.city NEW YORK
hcfmusp.publisher.country USA
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dc.description.index MEDLINE
hcfmusp.citation.scopus 6
hcfmusp.citation.wos 5
hcfmusp.affiliation.country Brasil


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