title: Epidemiology and microbiology of nosocomial pediatric candidemia at a northern Indian tertiary care hospital.
abstract: The availability and aggressive use of chemotherapeutic and immunosuppressive agents as well as broad-spectrum antibacterial agents have created a large population of patients who are at increased risk of acquiring infections with fungal organisms, especially Candida species. Present work was undertaken to study the epidemiology and microbiology of candidemia and Candida colonization in hospitalized children. A total of 323 suspected cases of septicemia were enrolled, of which blood culture from 7.4% subjects was positive for Candida species. In total, 57.3% subjects were colonized by Candida species at least at one of the tested sites. Of 337 isolates, 24.3, 71.5, 2.9, 0.59, and 0.59% were Candida albicans, Candida tropicalis, Candida krusei, Candida kefyr, and Candida lusitaniae, respectively. Antifungal susceptibility results show that fluconazole, itraconazole, and amphotericin B resistance is prevalent in 18.2, 2.4, and 3.6% of C. albicans isolates, and 21.1, 4.6, and 0.04% of C. tropicalis isolates, respectively. In a large number of cases, source of blood infection was patient's own colonizers, as shown by genetic matching. It was also noted that some strain types are circulating within the ward. High prevalence of non-albicans candidemia with high resistance to fluconazole is prevalent in North Indian hospitalized children.
authors.affiliation: Department of Microbiology, Chhatrapati Shahuji Maharaj Medical University (Erstwhile King George's Medical University), Lucknow, Uttar Pradesh, 226 003, India.
authors.forename: Avijit Kumar
authors.initials: AK
authors.lastname: Awasthi
authors.forename: Amita
authors.initials: A
authors.lastname: Jain
authors.forename: Shally
authors.initials: S
authors.lastname: Awasthi
authors.forename: Ankur
authors.initials: A
authors.lastname: Ambast
authors.forename: Kamlesh
authors.initials: K
authors.lastname: Singh
authors.forename: Vijendra
authors.initials: V
authors.lastname: Mishra
mesh_terms: D000935:Antifungal Agents / Q000494:pharmacology; D002175:Candida / Q000145:classification* / Q000187:drug effects / Q000302:isolation & purification*; D058387:Candidemia / Q000453:epidemiology* / Q000382:microbiology*; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D025141:Drug Resistance, Fungal; D005260:Female; D006761:Hospitals; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests
chemical_list: D000935:Antifungal Agents