title: Candida Associated Bloodstream Infections in Pediatric Hematology Patients: A Single Center Experience.
abstract: OBJECTIVE
  Candida-associated bloodstream infections are frequent and potentially life-threatening conditions in hematology patients. The aim of this study is to evaluate the characteristics, risk factors, and outcome of Candida-associated bloodstream infections in children with hematological diseases.
  
  
  METHODS
  The medical records of the patients with hematological diseases and hematopoietic stem cell transplantation (HSCT) recipients who were diagnosed as Candida-associated bloodstream infection between February 2010 and February 2014 were reviewed retrospectively.
  
  
  RESULTS
  Thirty episodes of candidemia involving 26 patients (38% female, and 62% male) with a median age of 7-year (range; 1 to 17) were noted. The incidence of candidemia in our study was 5.2 per 1000 hospital admissions. Infections with non-albicans Candida spp. occurred more frequently (63%) and C. krusei was the predominant microorganism among non-albicans Candida spp. (37%). Candida albicans was isolated from 11 of the 30 episodes (37%). Twenty-six of the episodes (88%) patients had a central venous catheter (CVC) prior to candidemia, and they were removed in 16 (62%). Thirty-day mortality rate was 20%. Isolated Candida spp, underlying disease and its status, presence of mucositis, neutropenia, using of broad spectrum antibiotics, corticosteroids or total parenteral nutrition were not identified as predictors of outcome. Multivariate analysis revealed that CVCs kept in place was the only significant factor associated with mortality (OR, 0.07; 95% CI, 0.006-0.716).
  
  
  CONCLUSIONS
  Candida-associated bloodstream infections were common in children with hematological diseases and HSCT recipients, particularly in patients with CVCs. In addition to appropriate antifungal therapy, CVC removal improves the outcome of candidemia in children with hematological disease.
authors.affiliation: Ankara Children's Hematology and Oncology Hospital, Department of Pediatric Hematology, Ankara, Turkey.
authors.forename: Dilek Gurlek
authors.initials: DG
authors.lastname: Gokcebay
authors.affiliation: Ankara Children's Hematology and Oncology Hospital, Department of Pediatric Hematology, Ankara, Turkey.
authors.forename: Nese
authors.initials: N
authors.lastname: Yarali
authors.affiliation: Ankara Children's Hematology and Oncology Hospital, Department of Pediatric Hematology, Ankara, Turkey.
authors.forename: Pamir
authors.initials: P
authors.lastname: Isik
authors.affiliation: Ankara Children's Hematology and Oncology Hospital, Department of Pediatric Hematology, Ankara, Turkey.
authors.forename: Cengiz
authors.initials: C
authors.lastname: Bayram
authors.affiliation: Ankara Children's Hematology and Oncology Hospital, Department of Pediatric Infectious Disease, Ankara, Turkey.
authors.forename: Aslinur
authors.initials: A
authors.lastname: Ozkaya-Parlakay
authors.affiliation: Ankara Children's Hematology and Oncology Hospital, Department of Pediatric Hematology, Ankara, Turkey.
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Kara
authors.affiliation: Ankara Children's Hematology and Oncology Hospital, Department of Pediatric Hematology, Ankara, Turkey.
authors.forename: Bahattin
authors.initials: B
authors.lastname: Tunc