Candidaemia in a Polish tertiary paediatric hospital, 2000 to 2010

Abstract

Data on the epidemiology of invasive Candida infections in paediatric patients in Europe are still limited. The aim of this retrospective study was to analyse the epidemiology of candidaemia in a tertiary paediatric hospital in Poland from 2000 to 2010. Using microbiological records, a total of 118 episodes of candidaemia were identified in 114 children, with an annual incidence of 0.35 episodes/1000 discharges. The highest incidences were found in the medical intensive care unit (5.28), and in neonatal intensive care (1.47). The mortality rate was 8.5%. Candida albicans and C. parapsilosis were the most prevalent species (39.8% and 35.6% respectively). The prevalence of non-albicans species increased from 12.5% in 2000 to 70% in 2010. No differences were found between C. albicans and C. non-albicans episodes in terms of demographics, risk factors or mortality. The highest resistance rates (overall 7.6%) were observed for fluconazole (4.3% in C. albicans, 7.1% in C. parapsilosis and 13.8% in other Candida species). Resistance to amphotericin B (2.5%) was limited to non-albicans isolates. The dynamic changes in species distribution and increasing resistance of fungal pathogens confirm the importance of epidemiological surveillance.

Epidemiology of Candida albicans and non-C.albicans of neonatal candidemia at a tertiary care hospital in western China

“…In the past two decades, there have been several cohort studies indicating that the cause of Candida bloodstream infection has shifted from C.albicans to non-C.albicans [19–21]. Widespread use of azole antifungal agents, especially fluconazole, was one of the reasons contributing to the increased isolation rate of non-C.albicans and the decreased isolation rate of C.albicans [22, 23].…”

Invasive candidiasis and candidaemia in neonates and children: update on current guidelines

“…Further to this, the prevalence of infections caused by non‐ albicans Candida spp. that may have less susceptibility to antifungal agents in vitro , has increased steadily, accounting for >50% of episodes of candidaemia in many surveys conducted in adults and children . According to recent epidemiological studies, C. glabrata and C. krusei have become more frequent among neutropaenic haematological patients compared with those with solid tumours or without neutropaenia .…”

Fungi as causative agents of healthcare-associated infections

“…Najczęściej kandydemie były notowane na oddziałach intensywnej terapii (0,76±0,56 przypadków na 1000 osobodni), noworodkowych (0,32±0,39 przypadków na 1000 osobodni), hematologicznych (0,26±0,2 przypadków na 1000 osobodni) i chirurgicznych (0,18±0,24 przypadków na 1000 osobodni) [11]. W populacji dziecięcej kandydemię notowano w Polsce w liczbie 0,35 przypadków na 1000 przyjęć/rok [12]. Dominującym gatunkiem jest Candida albicans, stanowi bowiem ponad 40% wszystkich gatunków.…”

“…Dominującym gatunkiem jest Candida albicans, stanowi bowiem ponad 40% wszystkich gatunków. Należy jednak zauważyć znaczny odsetek (ok. 35%) C. parapsilosis w populacji dziecięcej oraz przewagę gatunków innych niż C. albicans na oddziałach hematoonkologicznych, ze znacznym udziałem (24%) szczepów C. krusei, które naturalnie są niewrażliwe na flukonazol [11][12][13].…”