Candida colonization and candidemia in a pediatric intensive care unit

Singhi, Sunit; Rao, D. S. V. Raman; Chakrabarti, A.

doi:10.1097/01.pcc.0000298643.48547.83

Cited by 77 publications

(82 citation statements)

References 31 publications

(29 reference statements)

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“…This has been also reported in other studies which have pointed to the significant role of Candida colonization as an important risk factor for candidemia even in a non-neonatal population [12]. Moreover, several studies have shown that ICU patients with mucosal Candida colonization, particularly if multifocal, are at higher risk for invasive candidiasis, and that colonization selects a population amenable to antifungal prophylaxis or empirical therapy [31].…”

Section: Discussionmentioning

confidence: 50%

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Characteristics and risk factors of candidemia in pediatric intensive care unit of a tertiary care children's hospital in Egypt

Hegazi

Abdelkader

Zaki

et al. 2014

J Infect Dev Ctries

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Introduction: This study was conducted to determine characteristics of Candida colonization and candidemia in the pediatric intensive care unit (PICU) of a tertiary care children's hospital. Methodology: Patients between 6 months and 15 years of age consecutively admitted to the PICU of Mansoura University Children's Hospital in Mansoura, Egypt, during one year period, were evaluated for Candida colonization and candidemia. Susceptibility of Candida species isolated from blood to fluconazole and amphotericin B was determined by Etest. Results: Sixty-six patients without prior fluconazole prophylaxis had 88 episodes of candidemia, representing 19% of all cases with blood stream infections (BSIs). Candida albicans (CA) and non-albicans Candida (NAC) species accounted for 40% and 60% of candidemia episodes respectively. C. parapsilosis, C. tropicalis, and C. glabrata accounted for 25%, 17%, and 8% of NAC candidemias respectively. Fluconazole resistance was detected in 11.4% and 18.9% of CA and NAC isolates respectively. Of the fluconazole resistant NAC isolates, four were C. krusei. Amphotericin B resistance was detected in 17% of NAC isolates. Candida colonization was detected in 78.8% of patients. Compared to CA candidemia, higher risk for NAC candidemia was associated with age older than 1 year, Candida isolation from endotracheal tube (ETT) and from central venous catheter. Mortality rate was 42.4%, attributable mortality of candidemia was 16.7%. Regression analysis showed that the most significant independent predictors of death were ETT and mechanical ventilation (MV), MV longer than 7 days, and candiduria. Conclusions: This study presents important epidemiological features of Candida BSIs in a non-neonatal population.

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Section: Discussionmentioning

confidence: 50%

“…However, few data have been reported regarding the colonizationinfection shift outside the NICU where colonization by Candida species was found to be an independent predictor of candidemia in children undergoing treatment for severe sepsis or sepsis shock in PICU [12].…”

Section: Introductionmentioning

confidence: 99%

Characteristics and risk factors of candidemia in pediatric intensive care unit of a tertiary care children's hospital in Egypt

Hegazi

Abdelkader

Zaki

et al. 2014

J Infect Dev Ctries

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“…(14-17) Twenty-fi ve of forty-eight (52.1%) colonized patients carried C.albicans and 15/48 (31.25%) C.parapsilosis. Th e rate of C.parapsilosis colonization is modestly higher than data reported in other paediatric units (2,18,19), so it could be considered an important and distinctive feature of our NICU, requiring deeper analysis. We identifi ed as risk factors for Candida spp.…”

Section: Discussionmentioning

confidence: 39%

The burden of Candida species colonization in NICU patients: a colonization surveillance study

2017

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Fungal infections are an important cause of morbidity and mortality in neonatal intensive care units (NICUs). The identification of specific risk factors supports prevention of candidemia in neonates. Effective prophylactic strategies have recently become available, but the identification and adequate management of high-risk infants is still a priority. Prior colonization is a key risk factor for candidemia. For this reason, surveillance studies to monitor incidence, species distribution, and antifungal susceptibility profiles, are mandatory. Among 520 infants admitted to our NICU between January 2013 and December 2014, 472 (90.77%) were included in the study. Forty-eight out of 472 (10.17%) patients tested positive for Candida spp. (C.), at least on one occasion. All the colonized patients tested positive for the rectal swab, whereas 7 patients also tested positive for the nasal swab. Fifteen out of 472 patients (3.18%) had more than one positive rectal or nasal swab during their NICU stay. Moreover, 9 out of 15 patients tested negative at the first sampling, suggesting they acquired Candida spp. during their stay. Twenty-five of forty-eight (52.1%) colonized patients carried C.albicans and 15/48 (31.25%) C.parapsilosis. We identified as risk factors for Candida spp. colonization: antibiotic therapy, parenteral nutrition, the use of a central venous catheter, and nasogastric tube. Our experience suggests that effective microbiological surveillance can allow for implementing proper, effective and timely control measures in a highrisk setting.

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“…A study in India showed similar trends, adding the observation that central venous catheters were a risk factor for colonization. In the same study, C. tropicalis was the most common organism in blood cultures (Singhi et al, 2008). In our study, the median postnatal age at onset of infection was 21.75 days (range: 14-28 days); moreover, two cases were successfully treated using antibiotics within one week.…”

Section: Discussionmentioning

confidence: 72%

An outbreak of Candida parapsilosis fungemia among preterm infants

Guo

Zhang

et al. 2015

Genet. Mol. Res.

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ABSTRACT. In this article, we describe the first outbreak of Candida parapsilosis fungemia in our hospital. We examined a cluster of four nosocomial cases of C. parapsilosis fungemia that occurred in the neonatal intensive care unit (NICU) of the Affiliated Xingtai People's Hospital of Hebei Medical University over a two-week period. We ascertained patient parameters including clinical characteristics, blood and sputum cultures, and drug sensitivity test results. Cultures from eight blood samples obtained from the four infected preterm infants showed identical characteristics and were identified as C. parapsilosis. In order to determine the infection-related factors and to control the spread of the infection among the population, we immediately initiated the emergency plan. All four of the preterm infants recovered from the infection; there 18260 W. Guo et al.

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Candida colonization and candidemia in a pediatric intensive care unit

Abstract: Monitoring for colonization with Candida species in children undergoing treatment for severe sepsis or sepsis shock in PICU for >5 days may offer opportunity for early intervention for prevention of candidemia.

Cited by 77 publications

References 31 publications

Characteristics and risk factors of candidemia in pediatric intensive care unit of a tertiary care children's hospital in Egypt

Characteristics and risk factors of candidemia in pediatric intensive care unit of a tertiary care children's hospital in Egypt

The burden of Candida species colonization in NICU patients: a colonization surveillance study

An outbreak of Candida parapsilosis fungemia among preterm infants

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