Non-albicans Candida is the most common cause of candidemia in pediatric cancer patients.
OBJECTIVE
Candidemia is a serious infection that can severely complicate the care of children with cancer. We sought to determine the spectrum of Candida species in children with cancer, since effective therapy may depend on the species involved.


METHODS
A retrospective review of candidemia episodes in our pediatric oncology patients over a 9-year period was conducted. During this period azole prophylaxis was not routine in this group.


RESULTS
38 episodes of candidemia were identified: C. albicans 29%, C. tropicalis 26%, C. parapsilosis 24%, C. krusei 8%, C. glabrata 8%, and C. lusitaniae 5%. Non-albicans Candida was common in patients not receiving azole prophylaxis. Species typically susceptible to azoles were common among patients not using azoles. Death attributed to the fungal infection occurred in 21% of episodes, with nearly all the deaths occurring in patients with C. albicans and C. tropicalis.


CONCLUSIONS
C. albicans is not the predominant species in pediatric oncology patients experiencing candidemia, even in azole-naive patients.
Department of Pediatrics, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA. cmullen@mdanderson.org
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CA
Mullen
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Abd  El-Baki
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Samir
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Tarrand
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Rolston
D000293:Adolescent; D000935:Antifungal Agents / Q000627:therapeutic use; D001393:Azoles / Q000627:therapeutic use; D002175:Candida / Q000302:isolation & purification*; D002176:Candida albicans / Q000302:isolation & purification; D002177:Candidiasis / Q000150:complications* / Q000382:microbiology / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000382:microbiology; D009894:Opportunistic Infections / Q000150:complications* / Q000382:microbiology / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors
D000935:Antifungal Agents; D001393:Azoles