Risk factors for candidemia in a children's hospital.
Candida species are increasingly important nosocomial pathogens in critically ill children. A 2.3-fold increase in the rate of nosocomial candidemia at our 200-bed tertiary care children's hospital prompted a study to identify risk factors for this infection. Twenty-six cases were identified between 1992 and 1993, representing 21% of all nosocomial bloodstream infections. Candida albicans was the most frequent isolate (58%), followed by Candida parapsilosis (27%). A case-control study revealed that there was a statistically significant association between the occurrence of candidemia and placement of a central venous catheter in the femoral vein (P = .03), the use of a tunneled central venous catheter (P = .05), and prolonged hyperalimentation (P = .04). Patients with candidemia also were noted to have candiduria more often than controls (P = .003) and were more likely to have had topical antifungal agents prescribed (P = .04). Multivariate analysis showed that hyperalimentation was an independent risk factor for the development of candidemia. We conclude that measures must be taken to reduce these risk factors whenever possible.
MacDonald
L
L
Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109-0378, USA.
Baker
C
C
Chenoweth
C
C
D000293:Adolescent; D002177:Candidiasis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D006776:Hospitals, Pediatric; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D012307:Risk Factors