title: Candidaemia in a Polish tertiary paediatric hospital, 2000 to 2010.
abstract: Data on the epidemiology of invasive Candida infections in paediatric patients in Europe are still limited. The aim of this retrospective study was to analyse the epidemiology of candidaemia in a tertiary paediatric hospital in Poland from 2000 to 2010. Using microbiological records, a total of 118 episodes of candidaemia were identified in 114 children, with an annual incidence of 0.35 episodes/1000 discharges. The highest incidences were found in the medical intensive care unit (5.28), and in neonatal intensive care (1.47). The mortality rate was 8.5%. Candida albicans and C. parapsilosis were the most prevalent species (39.8% and 35.6% respectively). The prevalence of non-albicans species increased from 12.5% in 2000 to 70% in 2010. No differences were found between C. albicans and C. non-albicans episodes in terms of demographics, risk factors or mortality. The highest resistance rates (overall 7.6%) were observed for fluconazole (4.3% in C. albicans, 7.1% in C. parapsilosis and 13.8% in other Candida species). Resistance to amphotericin B (2.5%) was limited to non-albicans isolates. The dynamic changes in species distribution and increasing resistance of fungal pathogens confirm the importance of epidemiological surveillance.
authors.affiliation: Department of Clinical Microbiology and Immunology, The Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Dzierzanowska-Fangrat
authors.forename: Ewa
authors.initials: E
authors.lastname: Romanowska
authors.forename: Olga
authors.initials: O
authors.lastname: Gryniewicz-Kwiatkowska
authors.forename: Marek
authors.initials: M
authors.lastname: Migdał
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Witulska
authors.forename: Józef
authors.initials: J
authors.lastname: Ryżko
authors.forename: Piotr
authors.initials: P
authors.lastname: Kaliciński
authors.forename: Janusz
authors.initials: J
authors.lastname: Książyk
authors.forename: Paulina
authors.initials: P
authors.lastname: Nadkowska
authors.forename: Danuta
authors.initials: D
authors.lastname: Dzierzanowska
mesh_terms: D000293:Adolescent; D000935:Antifungal Agents / Q000494:pharmacology; D002175:Candida / Q000145:classification / Q000302:isolation & purification; D058387:Candidemia / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D025141:Drug Resistance, Fungal; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D011044:Poland / Q000453:epidemiology; D012189:Retrospective Studies; D016019:Survival Analysis; D062606:Tertiary Care Centers
chemical_list: D000935:Antifungal Agents
keywords: Epidemiology; candidaemia; fluconazole; paediatrics; resistance