Analysis of the epidemiological profile of positive urine cultures for fungal infection in Belém, Pará, in the post-COVID-19 pandemic scenario, with a focus on the Candida genus

Resumo

Candida-related nosocomial fungal infections represent a significant public health concern, particularly in the post-COVID-19 context. Data from northern Brazil remain scarce, underscoring the need for regional epidemiological studies. To describe the frequency of Candida-related fungal infections in hospital settings in Belém, Pará, Brazil, and to evaluate their distribution according to year, age group, sex, and etiological agent. Observational, retrospective, descriptive study analyzing 1,192 positive urine cultures for fungal infections collected at Laboratory Ruth Brazão between January 2020 and December 2023. Variables included etiological diagnosis, sample date, age group (WHO classification), and sex. Data were analyzed using Microsoft Excel, with qualitative variables expressed as absolute and relative frequencies and quantitative variables as mean ± standard deviation. A mean of 298 ± 111 positive cultures per year was recorded, with a peak in 2021 (n = 459; 38.51%). Women predominated (65.02%), and elderly individuals represented the largest age group (53.10%). Candida albicans was the most prevalent species (56.62%), followed by C. tropicalis (21.43%), C. parapsilosis (10.46%), and C. glabrata (7.43%). C. albicans remained the leading etiological agent of candiduria in Belém, while non-albicans Candida species — especially C. tropicalis and C. parapsilosis — showed considerable local relevance, raising questions about the applicability of the WHO fungal priority pathogens list to the regional context. The 2021 peak is likely attributable to pandemic-related immunosuppressive therapies. These findings highlight the need for region-specific surveillance strategies in northern Brazil.