title: Probiotic use and prevalence of candidemia and candiduria in a PICU.
abstract: OBJECTIVE
  To compare the prevalence of candidemia and candiduria before and after the introduction of routine use of probiotics in children who received broad-spectrum antibiotics in a PICU.
  
  
  METHODS
  Retrospective "before and after" study.
  
  
  METHODS
  A 12-bed PICU of a teaching hospital in India.
  
  
  METHODS
  Children 3 months to 12 years old, admitted to the PICU over two 9 months' time periods, who received broad-spectrum antibiotics for more than 48 hours.
  
  
  METHODS
  Three hundred forty-four patients enrolled between November 2008 and July 2009 after the introduction of routine use of probiotics served as the "probiotic group"; they had received one sachet twice a day of a probiotic mix (EUGI [Wallace Pharma, Goa, India] containing Lactobacillus acidophillus, Lactobacillus rhamnosum, Bifidobacterium longum, Bifidobacterium bifidum, Saccharomyces boulardii, and Streptococcus thermophilus) for 7 days. Three hundred seventy-six children enrolled between February 2007 and October 2007 served as "controls." Blood was sent for bacterial and fungal cultures if clinically indicated and urine catheter/bag specimen was submitted for bacterial and fungal culture twice a week as per unit's protocol.
  
  
  RESULTS
  Primary outcome was growth of Candida in blood (candidemia), and secondary outcomes were growth of Candida in urine (candiduria), nosocomial bloodstream infections, and urinary tract infections. Data were retrieved from the case records. Candidemia was seen in four of 344 patients (1.2%) in the probiotic group and in 14 of 376 (3.7%) in the control group (relative risk, 0.31; 95% CI, 0.10-0.94; p = 0.03). Candiduria was noted in 37 of 344 patients (10.7%) in the probiotic group and 83 of 376 (22%) in the control group (relative risk, 0.48; 95% CI, 0.34-0.7; p = 0.0001). The prevalence of nosocomial bloodstream infection and urinary tract infection in the probiotic and control groups was 20.3% and 26% (p = 0.07) and 14.2% and 19.1% (p = 0.08), respectively.
  
  
  CONCLUSIONS
  Routine use of a mix of probiotics in patients who receive broad-spectrum antibiotics could be a useful strategy to reduce the prevalence of candidemia and candiduria in the PICU.
authors: 1Department of Pediatrics, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India. 2Department of Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors: Suresh
authors: S
authors: Kumar
authors: Sunit
authors: S
authors: Singhi
authors: Arunloke
authors: A
authors: Chakrabarti
authors: Arun
authors: A
authors: Bansal
authors: M
authors: M
authors: Jayashree
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002175:Candida; D058387:Candidemia / Q000382:microbiology / Q000517:prevention & control; D002177:Candidiasis / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control / Q000652:urine; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D008297:Male; D019936:Probiotics / Q000627:therapeutic use*; D012189:Retrospective Studies; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000517:prevention & control
chemical_list: D000900:Anti-Bacterial Agents