Candida species bloodstream infections in hospitalised children: A 10-year experience.
In a 10-year retrospective study we assessed the epidemiology of candidemia and the association between the presence and removal of indwelling central venous catheters, antifungal use and clinical outcomes among hospitalised children. Demographic and clinical information were retrieved from the electronic medical records. One hundred six episodes of candidemia were identified in 83 unique patients. Candida parapsilosis was the most prevalent (52%) species, followed by C. albicans (25%). Non-oncologic children receiving fluconazole within 30 days of developing candidemia were most likely to develop C. parapsilosis infection (40%, P = 0.006), independent of total parenteral nutrition (odds ratio (OR) 2.5, 95% confidence interval (CI): 0.6-11, P = 0.3). Crude mortality rate was 12% and significantly higher for children less than 2 years (OR: 6.7, 95% CI: 1.9-23, P = 0.003), and those infected with C. lusitaniae (OR: 9, 95% CI: 1.6-51, P = 0.02). The aggregate use of antifungal agents decreased overtime (χ(2) : 16.7, P < 0.0001). Fluconazole remained the most common antifungal agent used during the study.
Department of Pediatric & Pharmacy, Alfred I. duPont Hospital for Children, Wilmington, Delaware, United States.
Shannon
S
Chan
Department of Pharmacy, Cincinnatti Children's Hospital, Cincinnati, Ohio, United States.
Elizabeth D
ED
Baley
Nemours, Department of Biomedical Research, Wilmington, Delaware, United States.|Department of Applied Economics and Statistics, University of Delaware, Newark, Delaware, United States.
Jobayer
J
Hossain
Department of Pediatrics, Vanderbilt University, Nashville, Tennessee, United States.
M Cecilia
MC
Di Pentima
D002175:Candida / Q000302:isolation & purification*; D058387:Candidemia / Q000453:epidemiology* / Q000401:mortality; D002648:Child; D002673:Child, Hospitalized; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D010414:Pennsylvania / Q000453:epidemiology; D012189:Retrospective Studies
Candida spp.; candidemia; paediatrics