title: [Age group, geographical incidence and patterns of antifungal susceptibility of Candida species causing candidemia in the Spanish paediatric population].
abstract: BACKGROUND
  There are few epidemiological studies on candidaemia in the paediatric population in Spain. We sought to determine the epidemiology of candidaemia in these patients.
  
  
  METHODS
  Prospective, observational and multicentre study in 44 Spanish hospitals. All candidaemia episodes in paediatric patients from 0 to 15 years old between January 2009 and February 2010 were studied.
  
  
  RESULTS
  There were 197 episodes and 200 species were isolated. The most frequent species was Candida parapsilosis sensu stricto (43%), followed by C. albicans (36%), C. tropicalis (6%), C. orthopsilosis, and C. glabrata (4%) respectively. C. albicans was the most prevalent in newborns, and C. parapsilosis was most frequent in the other age groups. As regards the regions of Spain, C. albicans was most prevalent in patients from Catalonia, the Balearic Islands and Canary Islands, and C. parapsilosis in patients from Andalusia, Castilla-León, Galicia, Valencia, and Madrid. The rate of resistance to fluconazole was 1.5% (4.1% with the new species-specific Clinical and Laboratory Standards Institute [CLSI] criteria). Fluconazole resistance was lower in neonates than the other age groups. The Neonatal Wards were the areas with most episodes (31.5%). In the multivariate analysis, the variables associated independently with candidaemia due to C. albicans were: catheter (OR: 5.967; 95% CI: 1.614-22.057; P=.007) and prematurity (OR: 2.229; 95% CI: 1.141- 4.631; P=.020).
  
  
  CONCLUSIONS
  The epidemiology of paediatric candidaemia varies between Spanish regions, but, globally, C. parapsilosis and C. albicans, are respectively, the first and second most frequently isolated species, and they show resistance rates to fluconazole of less than 5%.
authors: Servicio de Microbiología, Hospital Universitario La Paz, Madrid, España. jgarcia@hulp.insalud.es
authors: Julio
authors: J
authors: García-Rodríguez
authors: Emilia
authors: E
authors: Cantón
authors: Javier
authors: J
authors: Pemán
authors: Maria
authors: M
authors: Alvarez
authors: Guillermo
authors: G
authors: Ezpeleta
authors: Amelia
authors: A
authors: Gómez-Nieto
authors: Isabel
authors: I
authors: Iglesias
authors: Estrella
authors: E
authors: Martín-Mazuelos
authors: Inmaculada
authors: I
authors: Ramírez-de Ocariz
authors: Antonio
authors: A
authors: Rezusta
authors: Gloria
authors: G
authors: Royo-García
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000935:Antifungal Agents / Q000494:pharmacology*; D002175:Candida / Q000187:drug effects*; D058387:Candidemia / Q000453:epidemiology* / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D015994:Incidence; D007223:Infant; D008826:Microbial Sensitivity Tests; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology
chemical_list: D000935:Antifungal Agents