title: Epidemiologic and microbiologic evaluation of nosocomial infections associated with Candida spp in children: A multicenter study from Istanbul, Turkey.
abstract: The purpose of this study was to establish species distribution of Candida isolates from pediatric patients in Istanbul, Turkey, and to determine risk factors associated with nosocomial Candida infections.
  
  
  
  This study was conducted between June 2013 and June 2014 by participation of 7 medical centers in Istanbul. Candida spp strains isolated from the clinical specimens of pediatric patients were included. Clinical features were recorded on a standardized data collection sheet.
  
  
  
  A total of 134 systemic Candida infections were identified in 134 patients. The patients were admitted in pediatric and neonatal intensive care units (41.8% and 9.7%, respectively) and in pediatric wards (48.5%). Candida albicans was the most prevalent species (47%), followed by Candida parapsilosis (13.4%), Candida tropicalis (8.2%), Candida glabrata (4.5%), Candida lusitaniae (3.7%), Candida kefyr (2.2%), Candida guilliermondii (1.5%), Candida dubliniensis (0.7%), and Candida krusei (0.7%). Types of Candida infections were candidemia (50.7%), urinary tract infection (33.6%), surgical site infection (4.5%), central nervous system infection (3.7%), catheter infection (3.7%), and intra-abdominal infection (3.7%). In multivariate analysis, younger age (1-24 months) and detection of non-albicans Candida spp was found to be risk factors associated with candidemia (P = 0.040; odds ratio [OR], 4.1; 95% confidence interval [CI], 1.06-15.86; and P = 0.02; OR, 2.4; 95% CI, 1.10-5.53, respectively).
  
  
  
  This study provides an update for the epidemiology of nosocomial Candida infections in Istanbul, which is important for the management of patients and implementation of appropriate infection control measures.
authors.affiliation: Department of Pediatric Infectious Diseases, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey. Electronic address: sutcu13@yahoo.com.
authors.forename: Murat
authors.initials: M
authors.lastname: Sutcu
authors.affiliation: Department of Pediatric Infectious Diseases, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Nuran
authors.initials: N
authors.lastname: Salman
authors.affiliation: Department of Pediatric Infectious Diseases, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Hacer
authors.initials: H
authors.lastname: Akturk
authors.affiliation: Department of Pediatric Infectious Diseases, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.
authors.forename: Nazan
authors.initials: N
authors.lastname: Dalgıc
authors.affiliation: Department of Pediatric Infectious Diseases, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Ozden
authors.initials: O
authors.lastname: Turel
authors.affiliation: Department of Pediatric Infectious Diseases, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.
authors.forename: Canan
authors.initials: C
authors.lastname: Kuzdan
authors.affiliation: Department of Pediatric Infectious Diseases, Marmara University Medical Faculty, Istanbul, Turkey.
authors.forename: Eda Kepenekli
authors.initials: EK
authors.lastname: Kadayifci
authors.affiliation: Department of Pediatric Infectious Diseases, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Dicle
authors.initials: D
authors.lastname: Sener
authors.affiliation: Department of Pediatric Infectious Diseases, Okmeydani Education and Research Hospital, Istanbul, Turkey.
authors.forename: Adem
authors.initials: A
authors.lastname: Karbuz
authors.affiliation: Department of Microbiology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Zayre
authors.initials: Z
authors.lastname: Erturan
authors.affiliation: Department of Pediatric Infectious Diseases, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Ayper
authors.initials: A
authors.lastname: Somer
mesh_terms: D002175:Candida / Q000302:isolation & purification*; D002176:Candida albicans / Q000302:isolation & purification; D058387:Candidemia / Q000453:epidemiology* / Q000382:microbiology; D002177:Candidiasis / Q000453:epidemiology* / Q000382:microbiology; D002675:Child, Preschool; D003428:Cross Infection; D005260:Female; D006761:Hospitals; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D008297:Male; D012307:Risk Factors; D014421:Turkey / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology
keywords: Candida albicans; Systemic candidiasis; candidemia; candiduria; children; non-albicans Candida