Epidemiology of candidemia at a Children's hospital, 2002 to 2006.
BACKGROUND
There are few recent studies evaluating trends in the epidemiology of candidemia including changes in species or utilization of antifungal agents in children.


METHODS
We performed a retrospective case series of candidemia at our children's hospital from 2002 to 2006. Our objectives were to study trends in the rates of candidemia, demographic characteristics, Candida species, antifungal susceptibility, and antifungal utilization. These data were obtained from the electronic medical records.


RESULTS
There were 203 episodes of candidemia in 154 subjects. During the study period, the average rate of candidemia was 5.52 per 1000 patient-discharges and did not change throughout the study. The mean and median ages of subjects were 3 years versus 9 months, respectively, and 38% were less than 3 months of age. Gastrointestinal disorders were a common comorbid condition (33%), especially for subjects with multiple episodes of candidemia. Overall, Candida parapsilosis and Candida albicans caused 43% and 26% of episodes, respectively, and candidemia caused by Candida glabrata (5.3%-23%) and Candida krusei (0%-8.5%) increased during the study. Ninety-eight percent of C. albicans and C. parapsilosis isolates remained susceptible to all antifungal drugs. From 2003-2006, the use of antifungal agents increased from 79 days to 150 days per 1000 hospital-days.


CONCLUSIONS
While antifungal use at our hospital increased, candidemia rates remained stable. C. parapsilosis was the most common species but other non-C. albicans species increased during the study period. Local epidemiology should be monitored in pediatric populations for potential impact on management strategies.
Neu
Natalie
N
Departments of Pediatrics, Columbia University Medical Center, New York, New York, USA. nn45@columbia.edu
Malik
Mariam
M
Lunding
Amy
A
Whittier
Susan
S
Alba
Luis
L
Kubin
Christine
C
Saiman
Lisa
L
D000293:Adolescent; D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002175:Candida / Q000145:classification* / Q000302:isolation & purification*; D002177:Candidiasis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D003625:Data Collection / Q000379:methods; D003710:Demography; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D016469:Fungemia / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D008826:Microbial Sensitivity Tests; D009518:New York / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies
D000935:Antifungal Agents