title: Risk factors for candidemia mortality in hospitalized children.
abstract: OBJECTIVE
  To evaluate risk factors associated with death due to bloodstream infection caused by Candida spp. in pediatric patients and evaluate the resistance to the main anti-fungal used in clinical practice.
  
  
  METHODS
  This is a cross-sectional, observational, analytical study with retrospective collection that included 65 hospitalized pediatric patients with bloodstream infection by Candida spp. A univariate analysis was performed to estimate the association between the characteristics of the candidemia patients and death.
  
  
  RESULTS
  The incidence of candidemia was 0.23 cases per 1000patients/day, with a mortality rate of 32% (n=21). Clinical outcomes such as sepsis and septic shock (p=0.001), comorbidities such as acute renal insufficiency (p=0.01), and risks such as mechanical ventilation (p=0.02) and dialysis (p=0.03) are associated with increased mortality in pediatric patients. The resistance and dose-dependent susceptibility rates against fluconazole were 4.2% and 2.1%, respectively. No resistance to amphotericin B and echinocandin was identified.
  
  
  CONCLUSIONS
  Data from this study suggest that sepsis and septic shock, acute renal insufficiency, and risks like mechanical ventilation and dialysis are associated with increased mortality in pediatric patients. The mortality among patients with candidemia is high, and there is no species difference in mortality rates. Regarding the resistance rates, it is important to emphasize the presence of low resistance in this series.
authors.affiliation: Hospital Pequeno Príncipe, Curitiba, PR, Brazil; Faculdades Pequeno Príncipe, Curitiba, PR, Brazil; Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, PR, Brazil. Electronic address: fabio.motta.hpp@gmail.com.
authors.forename: Fabio Araujo
authors.initials: FA
authors.lastname: Motta
authors.affiliation: Faculdades Pequeno Príncipe, Curitiba, PR, Brazil; Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, PR, Brazil; Universidade Federal do Paraná (UFPR), Hospital de Clínicas, Curitiba, PR, Brazil.
authors.forename: Libera Maria
authors.initials: LM
authors.lastname: Dalla-Costa
authors.affiliation: Faculdades Pequeno Príncipe, Curitiba, PR, Brazil; Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, PR, Brazil; Universidade Federal do Paraná (UFPR), Hospital de Clínicas, Curitiba, PR, Brazil.
authors.forename: Marisol Dominguez
authors.initials: MD
authors.lastname: Muro
authors.affiliation: Hospital Pequeno Príncipe, Curitiba, PR, Brazil.
authors.forename: Mariana Nadal
authors.initials: MN
authors.lastname: Cardoso
authors.affiliation: Faculdades Pequeno Príncipe, Curitiba, PR, Brazil; Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, PR, Brazil.
authors.forename: Gledson Luiz
authors.initials: GL
authors.lastname: Picharski
authors.affiliation: Faculdades Pequeno Príncipe, Curitiba, PR, Brazil.
authors.forename: Gregory
authors.initials: G
authors.lastname: Jaeger
authors.affiliation: Secretaria Municipal da Saúde de Curitiba, Curitiba, PR, Brazil.
authors.forename: Marion
authors.initials: M
authors.lastname: Burger
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D001938:Brazil / Q000453:epidemiology; D002175:Candida / Q000302:isolation & purification; D058387:Candidemia / Q000097:blood / Q000188:drug therapy / Q000401:mortality*; D002673:Child, Hospitalized; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D009026:Mortality; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D000935:Antifungal Agents
keywords: Blood culture; Bloodstream infection; Candidemia; Hemocultura; Infecção da corrente sanguínea; Mortalidade pediátrica; Pediatric mortality