Candidemia in a pediatric intensive care unit

Singhi, Sunit; Reddy, Thimmapuram Chandra Sekhara; Chakrabarti, Arup

doi:10.1097/01.pcc.0000123550.68708.20

Cited by 61 publications

(62 citation statements)

References 39 publications

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“…Despite the extensive use of fluconazole, the susceptibility rate to this agent remains very high (99.4% of C. albicans and C. parapsilosis isolates), similar to that reported by other authors (3,10), and it has even increased since our last study 10 years ago (14). Furthermore, as C. glabrata and C. krusei are very infrequent in the pediatric setting (2,3,10,12,14,22,23,26), fluconazole is still a reasonable option for fungemia treatment before species identification, except in children with prior azole exposure, as is recommended by the latest guidelines published (7,11). Except intrinsically resistant species (T. asahii and R. glutinis), echinocandins show a broad antifungal activity; only two C. parapsilosis isolates and one C. tropicalis isolate were resistant to micafungin or/and anidulafungin.…”

Section: Discussionsupporting

confidence: 65%

Epidemiology and Antifungal Susceptibility of Bloodstream Fungal Isolates in Pediatric Patients: a Spanish Multicenter Prospective Survey

et al. 2011

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Data on fungemia epidemiology and antifungal susceptibility of isolates from children are scarce, leading frequently to pediatric empirical treatment based on available adult data. The present study was designed to update the epidemiological, mycological, and in vitro susceptibility data on fungal isolates from children with fungemia in Spain. All fungemia episodes were identified prospectively by blood culture over 13 months at 30 hospitals. Tests of susceptibility to amphotericin B, flucytosine, fluconazole, itraconazole, posaconazole, voriconazole, anidulafungin, caspofungin, and micafungin were performed at participant institutions by a microdilution colorimetric method. New species-specific clinical breakpoints for fluconazole, voriconazole, and echinocandins were also applied. A total of 203 episodes of fungemia in 200 children were identified. A higher proportion of fungal isolates was from general wards than intensive care units (ICU). Candida parapsilosis (46.8%), Candida albicans (36.5%), Candida tropicalis (5.9%), Candida glabrata (3.9%), and Candida guilliermondii (2.5%) were the leading species. C. parapsilosis was the predominant species except in neonates. C. albicans was the most frequent in neonatal ICU settings (51.9%). Intravascular catheter (79.3%), surgery (35%), prematurity (30%), and neutropenia (11%) were the most frequent predisposing factors. Most Candida isolates (95.1%) were susceptible to all antifungals. When the new species-specific clinical breakpoints were applied, all C. parapsilosis isolates were susceptible to echinocandins except one, which was micafungin resistant. This is the largest published series of fungemia episodes in the pediatric setting. C. parapsilosis is the most prevalent species in Spain, followed by C. albicans and C. tropicalis. Resistance to azole and echinocandin agents is extremely rare among Candida species. The fluconazole resistance rate in Spain has decreased in the last 10 years.

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Section: Discussionsupporting

confidence: 65%

Epidemiology and Antifungal Susceptibility of Bloodstream Fungal Isolates in Pediatric Patients: a Spanish Multicenter Prospective Survey

et al. 2011

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“…Hypokalemia was most frequently found in females however in the present study, hypokalemia is not significantly associated with females rather it is distributed equally in males as well as females. 2 Hypokalemia is also a common problem in pediatric intensive care unit patients; this has been reported by Singhi S et al 4 In the present age group between 40 to 60 were most affected and less than 20 years of age group individuals are the least affected.…”

Section: Discussionsupporting

confidence: 52%

Hypokalemia in hospitalized patients in tertiary care teaching hospital Belagavi, Karnataka, India: a retrospective study

2017

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Background: Hypokalemia is well known condition in which serum potassium levels falls less than the normal level (normal range 3.5 to 5.1mmol/L). It has adverse effect on cardiac rhythm, blood pressure.1 The objective of the study was to look for causes and associated factors of hypokalemia.Methods: Patients age, sex, potassium value and primary diagnosis of hypokalemia patients collected from tertiary care teaching hospital retrospectively. Hypokalemia patients are classified based on the severity of hypokalemia, age, sex and primary diagnosis. Results: Study reveals that both males and females are equally affected by hypokalemia, individuals with age between 40 to 60 are most affected and less than 20 are least affected by hypokalemia.Conclusions: Hypokalemia is significantly associated with gastrointestinal and genitourinary disorders when compared with other disorders.

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“…Other Indian studies also have documented shift to these species, C. tropicalis being the most commonly isolated. 3,4 Emergence of Candida spp. other than C. albicans is due to selection of less susceptible species by the pressure of antifungal agent such as ß uconazole apart from associated risk factors and underlying disorders.…”

Section: Discussionmentioning

confidence: 99%

“…other than C. albicans. 3,4 Candida spp., which have been implicated are C. tropicalis, C. glabrata and C. parapsilosis. Previous studies have suggested that possible risk factors for candidaemia are antibiotic therapy, chemotherapy, presence of intravascular catheters, malignancy, surgery, parenteral nutrition, intensive care unit stay and prior fungal colonization.…”

Section: Abstract: Candidaemia Candida Tropicalis Candida Sppmentioning

confidence: 99%

<i>Candida </i>spp. other than <i>Candida albicans</i>: A major cause of fungaemia in a tertiary care centre

Shivaprakasha¹,

Radhakrishnan²,

Karim³

2007

Indian J Med Microbiol

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Candidemia in a pediatric intensive care unit

Abstract: Nonalbicans Candida accounted for 70% of candidemia in a pediatric intensive care unit. High-risk surveillance blood cultures aided diagnosis in about half the patients. Severity of illness and isolation of C. tropicalis were significant predictors of mortality.

Cited by 61 publications

References 39 publications

Epidemiology and Antifungal Susceptibility of Bloodstream Fungal Isolates in Pediatric Patients: a Spanish Multicenter Prospective Survey

Epidemiology and Antifungal Susceptibility of Bloodstream Fungal Isolates in Pediatric Patients: a Spanish Multicenter Prospective Survey

Hypokalemia in hospitalized patients in tertiary care teaching hospital Belagavi, Karnataka, India: a retrospective study

<i>Candida </i>spp. other than <i>Candida albicans</i>: A major cause of fungaemia in a tertiary care centre

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