Epidemiology of Candidemia at a Children's Hospital, 2002 to 2006

Neu, Natalie; Malik, Mariam; Lunding, Amy; Whittier, Susan; Alba, Luis; Kubin, Christine J.; Saiman, Lisa

doi:10.1097/inf.0b013e3181a0d78d

Cited by 84 publications

(89 citation statements)

References 30 publications

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“…These findings are in accordance with the same increasing trend recorded in other studies where NAC BSIs were more prevalent than CA BSIs, with C.parapsilosis, C. tropicalis and C. glabrata being the most common NAC species causing infections in intensive care units [6,7].…”

Section: Discussionsupporting

confidence: 81%

“…NAC species, particularly C. parapsilosis and C. tropicalis, account for almost half of invasive Candida infections in pediatric patients [4,5]. Nonalbicans Candida became more frequent causative agents for invasive fungal infections in the ICU with high transmission of C. parapsilosis [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

“…A case of candidemia was defined as one or more positive blood cultures obtained by a peripheral venipuncture or through an indwelling central venous catheter (CVC) that yielded growth of any Candida species [7,14]. Concomitant bacteremia was defined as the isolation of bacterial species from blood within 24 hours since the initial positive fungal blood culture [15].…”

Section: Case Definitionsmentioning

confidence: 99%

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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: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Section: Case Definitionsmentioning

confidence: 99%

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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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“…-Candidemia persistente: Persistencia de hemocultivos (HCs) positivos a las 72 h del inicio de un tratamiento antifúngico efectivo. Ocurre en 10-30% de las infecciones invasoras por Candida spp [3][4][5] .…”

Section: Definicionesunclassified

Candidiasis invasoras en recién nacidos: diagnóstico, tratamiento y prevención

Izquierdo

Santolaya

2014

Rev. chil. infectol.

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“…Previous study had demonstrated that infection rate with Candida species was increased around 10 folds among neonates in a five years duration (Dutta and Palazzi, 2011). The mortality rates due to invasive candidiasis are high and range from 20 to 30% (Kuzucu et al, 2008;Neu et al, 2009;Singhi and Deep, 2009) that can be increased up to 50% if there is a delay in appropriate laboratory diagnosis (Roilides et al, 2004;Vendettuoli et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of semi-nested polymerase chain reaction (PCR) and mannan antigen detection compared to blood culture for diagnosis of candidemia

Al-Kasaby¹,

Kheir²,

Mefreh³

et al. 2017

Afr. J. Microbiol. Res.

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Invasive Candida infections have emerged as an important pathogen in the last decade, especially in immunocompromized patients. The aim of the present study was to evaluate the detection of Candida species in blood samples from pediatric patients with sepsis by blood culture method versus antigen detection method by enzyme linked immunosorbent assay (ELISA) and molecular method by polymerase chain reaction (PCR). This cross-sectional study was carried out on children at Mansoura University Children Hospital (MUCH) with the presence of clinical signs suggesting sepsis with absence of prior antifungal therapy. Laboratory diagnosis included blood culture, mannan antigen detection of Candida species by ELISA and semi-nested PCR. Candida species were detected by blood culture in 15.6% of the children and was detected by PCR and antigen detection in 20% for each. Candidemia was more frequently detected among patients with central venous lines (38.5%), children with Diabetes Mellitus (DM) (23.1%) and children with frequent blood transfusions (15.4%). However, these risk factors were not statistically significant. Mortality rate among children with candidemia was 42.9%. The sensitivity, specificity, and accuracy of antigen detection method by ELISA compared to culture, were 71.4, 89.5 and 86.7%, respectively. The sensitivity, specificity and accuracy of semi-nested PCR compared to culture were 85.7, 92.1 and 91.1% respectively. It can be concluded from this study that Candida species is a frequent pathogen associated with pediatric sepsis. Blood culture though is a reliable laboratory method for its diagnosis may lack sensitivity and requires prolonged time. Seminested PCR for detection of candidemia is sensitive, specific and accurate method. Mannan antigen detection by ELISA is rapid and easy; however, it may lacks specificity; it can be used as a preliminary method for screening. Further studies are recommended to detect the appropriate laboratory algorithm for early diagnosis of candidemia to start antifungal therapy appropriately.

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Epidemiology of Candidemia at a Children's Hospital, 2002 to 2006

Cited by 84 publications

References 30 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

Candidiasis invasoras en recién nacidos: diagnóstico, tratamiento y prevención

Evaluation of semi-nested polymerase chain reaction (PCR) and mannan antigen detection compared to blood culture for diagnosis of candidemia

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