Invasive Candidiasis in Pediatric Patients at King Fahad Medical City in Riyadh, Saudi Arabia: A 5-year Retrospective Study

Abstract

BackgroundInvasive candidiasis in children is associated with high morbidity and mortality. We aim to identify predisposing factors, species distribution, antifungal susceptibility, and outcomes among patients with candidemia.MethodsA data collection form composed of seven sections including 51 questions was designed to gather demographic and clinical information. We collected data from all 129 patients with invasive candidiasis from January 2010 to January 2015.ResultsThe 129 patients had the following risk factors: 30 (23.26%) were premature, 34 (26.36%) had low birth weight, 59 (45.74%) had a central venous catheter, 21 (16.28%) had a malignancy, 20 (15.5%) received immunotherapy, and 56 (43.41%) received ventilator support. A multivariate analysis revealed a more than two-fold mortality rate in patients who had vegetation in the heart (OR 2.9), and patients who had Candida isolated from their blood were more than twice as likely to die as patients with Candida isolated from other sites (OR 2.2). A total of 48.33% of patients on ventilator support died, and 26.09% of patients who were not on ventilator support died (P = 0.009); 43.75% of patients in the intensive care unit (ICU) died vs. only 24.49% of patients who were not in the ICU (P = 0.03). C. parapsilosis exhibited the highest mortality rate among all Candida species (56.2%).ConclusionThe study revealed that C. albicans was the most common isolate among all Candida species. Mechanical ventilation and an ICU stay were significant risk factors for death in children with invasive candidiasis.Disclosures All authors: No reported disclosures.

Prevalence and species distribution of Candida bloodstream infection in children and adults in two teaching university hospitals in Egypt: first report of Candida kefyr

“…In Saudi Arabia at a children's hospital at King Fahad Medical City, between January 2010 and January 2011, the most NAC included were C. tropicalis (23%) and C. parapsilosis ). Candida famata (5.7%), C. lusitaniae (4.1%) and glabrata (2.5%) [36]. Similar to our results, C. tropicalis was the 2nd most common cause of candidemia after C. albicans in Egyptian study during 2017 [24].…”

CandidaBloodstream Infection: Changing Pattern of Occurrence and Antifungal Susceptibility over 10 Years in a Tertiary Care Saudi Hospital

“…Candida tropicalis is the most frequently isolated among the nonalbicans group. In Saudi Arabia, Candida tropicalis has been the main species isolated among NAC (nonalbicans Candida) in both adult and pediatric population in most of the studies reported followed by Candida glabrata [6,[25][26][27]30]. Risk factors for the emergence of nonalbicans Candida include increasing use of an antifungal regimen specially fluconazole, use of broad-spectrum antibiotics, and the increasing number of immunocompromised patients [37,49,50].…”

“…Risk factors for invasive Candida across many studies from Saudi are consistent and similar to what is reported internationally. Use of broad-spectrum antibiotics, admission to ICU, and central vascular access were the main reported [6,29,30,53].…”

“…Over the last two decades, Candida has emerged as one of the most important pathogens causing nosocomial bloodstream infection in both adults and children worldwide [1][2][3][4][5][6]. Candida is part of our normal flora, and more than 200 species have been described, but only 10% are known to cause human infections [7].…”

Incidence of Candida Species Infections in a Military Hospital in Al-Kharj, Saudi Arabia

“…Over the last decades, Candida has emerged as one of the most important microorganisms causing nosocomial bloodstream infection in both adults and children worldwide [1][2][3][4][5][6]. Candida is a part of normal flora, and has more than 200 species, but only 10% of Candida species are known to cause human infections [7].…”