Invasive candidiasis in pediatric intensive care patients: epidemiology, risk factors, management, and outcome

Filioti, Joanna; Spiroglou, Kleomenis; Roilides, Emmanuel

doi:10.1007/s00134-007-0672-5

Cited by 105 publications

(100 citation statements)

References 89 publications

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“…Admission to PICU from inpatient ward, ETT and MV were also associated with candidemia in general, higher NAC than CA, and increased risk for mortality (Tables 1,3,4). Few studies have compared the risk factors between patients with CA and NAC BSI in the non-neonatal pediatric population and found no difference in the risk factors between patients with CA and NAC BSI [5,21].…”

Section: Discussionmentioning

confidence: 99%

“…However, an increasing role of non-albicans Candida (NAC) species, some of which are intrinsically or potentially resistant to antifungal agents, has been observed. 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%

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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: 99%

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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“…Depending on the magnitude of damage, disease ensues, which can be acute and/or recurrent in nature (4,(17)(18)(19). As a result, C. albicans infections are recognized as a serious public health challenge with high clinical and socioeconomic importance, representing one of the most prevalent agents identified in nosocomial infections (10,20,21).…”

Section: Candida Albicans: a Versatile Fungal Pathogenmentioning

confidence: 99%

Candida albicans Pathogenesis: Fitting within the Host-Microbe Damage Response Framework

et al. 2016

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f Historically, the nature and extent of host damage by a microbe were considered highly dependent on virulence attributes of the microbe. However, it has become clear that disease is a complex outcome which can arise because of pathogen-mediated damage, host-mediated damage, or both, with active participation from the host microbiota. This awareness led to the formulation of the damage response framework (DRF), a revolutionary concept that defined microbial virulence as a function of host immunity. The DRF outlines six classifications of host damage outcomes based on the microbe and the strength of the immune response. In this review, we revisit this concept from the perspective of Candida albicans, a microbial pathogen uniquely adapted to its human host. This fungus commonly colonizes various anatomical sites without causing notable damage. However, depending on environmental conditions, a diverse array of diseases may occur, ranging from mucosal to invasive systemic infections resulting in microbe-mediated and/or host-mediated damage. Remarkably, C. albicans infections can fit into all six DRF classifications, depending on the anatomical site and associated host immune response. Here, we highlight some of these diverse and site-specific diseases and how they fit the DRF classifications, and we describe the animal models available to uncover pathogenic mechanisms and related host immune responses.

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“…1 Among them, Candida species have been the dominant type representing the majority of blood stream infections (BSI) and associated catheter-related BSI with a rate of 10%. 2 Recent studies have reported increased incidences of other Candida species, especially Candida parapsilosis besides Candida tropicalis and Candida glabrata.…”

Section: Introductionmentioning

confidence: 99%

Reasons for Failure of Antifungal-lock Therapy with Caspofungin: Need for Higher Concentrations

İşgüder¹,

Ceylan²,

Sandal³

et al. 2017

cayd

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Antifungal-lock therapy (AfLT) has arrived as an investigational approach for preventing catheter removal with limited clinical evidence of its efficiency. The principle of AfLT consists of catheter lumen replenishment by a selected antimicrobial agent and then locking it for an alternative treatment to eradicate the microbes embedded in endoluminal biofilms. Herein, we report a pediatric hematology-oncology patient with Candida parapsilosis-related central venous access device infection in which catheter removal was performed despite the systemic and intraluminal caspofungin treatment. For now, we recommend higher doses of caspofungin for AfLT especially in Candida parapsilosis-related catheter infections. Keywords: Antifungal-lock technique, Candida species, caspofungin, catheter Antifungal kilit tekniği (AfKT) kateter çıkarılmasını engellemek amacı ile etkinliği hakkında kısıtlı verinin olduğu bir deneysel yaklaşım olarak karşımıza çıkmaktadır. Bu teknikte endoluminal biyofilmler içine gömülü olan etkenlerin eradike edilmesi için katater lümeni, seçilen antimikrobiyal ajanla doldurularak kapatılır. Burada yoğun bakım servisimizde yatan ve Candida parapsilosis ilişkili santral venöz kateter enfeksiyonu olan bir hematoloji-onkoloji hastasından gerek intraluminal gerekse sistemik kaspofungin tedavisine rağmen kateteri çıkartmak zorunda kalışımızı raporladık. Özellikle Candida parapsilosis ilişkili kateter enfeksiyonlarının AfKT ile tedavi edilebilmesi için daha yüksek dozda kaspofungin kullanılmasını önermekteyiz. Anahtar Kelimeler: Antifungal kilit tekniği, Candida türleri, kaspofungin, kateter AbstractÖz

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Invasive candidiasis in pediatric intensive care patients: epidemiology, risk factors, management, and outcome

Cited by 105 publications

References 89 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

Candida albicans Pathogenesis: Fitting within the Host-Microbe Damage Response Framework

Reasons for Failure of Antifungal-lock Therapy with Caspofungin: Need for Higher Concentrations

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