Candidemia in children: Epidemiology, prevention and management

Mantadakis, Elpis; Pana, Zoe Dorothea; Zaoutis, Theoklis E.

doi:10.1111/myc.12792

Cited by 45 publications

(40 citation statements)

References 107 publications

(194 reference statements)

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“…It may be due to the intersection of exposure and Candida infection. However, 60%‐70% of paediatric ICU patients with Candida bloodstream infection are colonised with the same Candida spp., indicating that some exposed groups will progress to candidaemia or have occurred but not been diagnosed.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of Candida mannan antigen and anti‐mannan IgG and IgM antibodies for Candida infection

Wang

Luo

Zhang

et al. 2019

Mycoses

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Summary Objective To assess the diagnostic value of serum Candida mannan antigen (MN) and anti‐mannan IgG and IgM antibodies for candidiasis. Methods This study was a prospective cohort study. Clinical data and venous blood samples from 23 medical centres in Beijing, China were collected between 1 January 2017 and 31 December 2018. All collected specimens were tested within one week for serum Candida MN and IgG and IgM antibodies using an ELISA kit. Results A total of 452 patients were enrolled, including 188 patients in the Candida exposure groups (56 patients with Candida bloodstream infection, 69 patients with Candida‐positive tracheal aspirate cultures and 63 patients with Candida‐positive urine cultures) and 264 patients in the control groups (212 healthy controls and 52 patients with bacteraemia). The receiver operating characteristic (ROC) curve of the 56 patients with Candida bloodstream infection and 212 healthy controls showed that serum MN and IgG had good diagnostic value. The area under the ROC curve (AUC) values were 0.812 (95% CI, 0.750‐0.873) and 0.866 (95% CI, 0.808‐0.924), respectively, wherein the MN specificity and sensitivity were 86.79% and 60.71%, and the IgG were 84.43% and 80.36%, respectively. The AUC of the combination of serum MN and IgG was 0.871(95% CI, 0.813‐0.929), and the specificity and sensitivity were 93.87% and 57.14%. Conclusions The serum levels of Candida MN and its IgG antibody have diagnostic value for Candida bloodstream infection, and combination of MN and IgG can improve diagnostic specificity and may provide a new approach for diagnosis of candidaemia.

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Section: Discussionmentioning

confidence: 99%

Diagnostic value of Candida mannan antigen and anti‐mannan IgG and IgM antibodies for Candida infection

Wang

Luo

Zhang

et al. 2019

Mycoses

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“…The widespread use of broad‐spectrum antibiotics may also account for the increase in candidaemia cases in recent years . However, premature birth, prolonged stay at the intensive care unit (ICU) and immaturity are the main predisposing factors in neonates and children …”

Section: Introductionmentioning

confidence: 99%

“…1 However, premature birth, prolonged stay at the intensive care unit (ICU) and immaturity are the main predisposing factors in neonates and children. [2][3][4][5][6] The epidemiology of candidaemia has changed in the last decades. 7 Although Candida albicans has been mainly responsible for the majority of hospital-acquired candidaemia cases, non-albicans Candida species, that is C. parapsilosis, C. glabrata, C. tropicalis, C. krusei and C. guilliermondii, currently constitute a large proportion of Candida-related infections.…”

Section: Introductionmentioning

confidence: 99%

Epidemiological features of nosocomial candidaemia in neonates, infants and children: A multicentre study in Iran

Ahangarkani

Shokohi

Rezai

et al. 2020

Mycoses

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Summary Nosocomial bloodstream candidaemia is a life‐threatening fungal infection with high morbidity and mortality, especially among paediatric patients undergoing intensive immunosuppressive therapy. Limited data on the epidemiology of candidaemia and susceptibility profiles are available for Iran. To characterise candidaemia epidemiology, comorbidity risk factors, species distribution, and antifungal susceptibility profiles among paediatric patients in Iran. This observational cross‐sectional study enrolled 26 189 patients <18 years old at three reference paediatric hospitals in Mazandaran and Tehran over 2 years. Blood samples from patients with suspected fungal bloodstream infection were analysed using the BACTEC culture system. Fungal isolates were identified using matrix‐assisted laser desorption ionisation time‐of‐flight mass spectrometry (MALDI‐TOF) and DNA sequencing. Antifungal susceptibility testing was performed using the Clinical and Laboratory Standards Institute broth microdilution guideline. We observed 109 episodes of nosocomial candidaemia in paediatric patients with or without immunosuppressive therapy. The most common healthcare‐associated factor was central vascular catheter use (97%). The all‐cause mortality rate was 40%, of which 48% was attributable to candidaemia. While Candida albicans was the most frequent causative agent (49%), emerging and uncommon Candida species were also isolated. Candidaemia mortality by non‐albicans Candida species was significantly higher than that by C. albicans (P < .05). All fluconazole‐resistant species were non‐albicans Candida species. Uncommon Candida species with reduced susceptibility to antifungals are emerging as major agents of nosocomial candidaemia in high‐risk paediatric patients in Iran. Appropriate source control, antifungal regimens and improved antifungal stewardship are warranted for managing and decreasing the burden of nosocomial candidaemia.

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“…The annual incidence rate of candidemia is estimated to be 3.88 per 100,000 inhabitants, while reported incidence rates range from 1.0 to 10.4 [4]. Moreover, candidemia is the leading cause of invasive fungal infections in hospitalized children, particularly those undergoing intensive chemotherapy for acute leukemia and heterologous stem cell transplantation [5]. There are approximately two hundreds of Candida species, but those most commonly associated with invasive disease in humans are C. albicans, C. tropicalis, C. parapsilosis, C. glabrata, C. krusei, and C. auris [6].…”

Section: Introductionmentioning

confidence: 99%

Candidemia in Children with Malignancies: Report from the Infection Working Group of the Hellenic Society of Pediatric Hematology-Oncology

Vasileiou

Paisiou

Tsipou

et al. 2020

JoF

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Candidemia is an important cause of morbidity and mortality especially in immunocompromised and hospitalized patients. We retrospectively collected data of candidemia cases that occurred in the seven Hematology-Oncology Departments/Units of Greece and the Stem Cell Transplant Unit between 2015 and 2019. In total, 19 episodes of candidemia in 19 patients were recorded. The majority of the patients (78.9%) had at least one risk factor for candidemia. The most frequent risk factors associated with candidemia observed in our patients were prolonged duration of hospitalization (30 days, range 1–141), presence of a central venous catheter at diagnosis of candidemia (73.7%) and antibiotics use during the last two weeks (84.2%). Candida parapsilosis was the most common species isolated accounting for 42.1%, followed by C. albicans (26.3%) and C. famata (15.8%). Nearly all of the patients (84.2%) received antifungal monotherapy with liposomal amphotericin B or echinocandins. The central venous catheter was removed in 78.6% of patients and the median time between the first positive blood culture and catheter removal was 3 days (range 1–9). Mortality at 28 days was 26.3%. In conclusion, a predominance of non-albicans species was observed in our study in conformity with the global trend.

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Candidemia in children: Epidemiology, prevention and management

Cited by 45 publications

References 107 publications

Diagnostic value of Candida mannan antigen and anti‐mannan IgG and IgM antibodies for Candida infection

Diagnostic value of Candida mannan antigen and anti‐mannan IgG and IgM antibodies for Candida infection

Epidemiological features of nosocomial candidaemia in neonates, infants and children: A multicentre study in Iran

Candidemia in Children with Malignancies: Report from the Infection Working Group of the Hellenic Society of Pediatric Hematology-Oncology

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