Invasive candidosis in pediatric patients

Abstract

OBJECTIVE: To analyze invasive Candida infections in pediatric patients and to examine the outcome of disease. METHODS: An observational prospective study was carried out of microbiologically documented cases of invasive candidosis in neonates, infants and children at Hippokration Hospital from December 1993 to July 1995. RESULTS: Thirty-nine cases of invasive candidosis (mainly candidemia and candiduria) occurred in 38 patients aged 3 days to 14 years, 21 (54%) having occurred in patients aged <1 month. The incidence was 10.1/1000 admissions in the two neonatal departments versus 1.1/1000 for all other pediatric departments, including oncology (p<0.01). The most frequent causes of hospitalization were premature birth or perinatal problems and surgery. Thirty-five strains of Candida albicans, 10 of C. parapsilosis and eight of other or unidentified species were isolated. Non-C. albicans isolates, especially C. parapsilosis and C. glabrata, exhibited higher minimal inhibitory concentrations of azoles as compared with C. albicans. Thirteen patients (34%), all candidemic, died within 0--40 days. Untreated patients more frequently had positive cultures up to time of death (p<0.0001) and died (p=0.0006). CONCLUSIONS: Invasive candidosis is frequent in pediatric patients, especially premature neonates, and is associated with increased mortality. With early diagnosis and initiation of therapy the outcome is favorable.

Prospective study on fungemia in children with cancer: analysis of 35 cases and comparison with 130 fungemias in adults

“…Also, the outcome was similar in both children and adults with cancer and fungal bloodstream infection, and similar (11.4-31.4%) to the outcome reported from other studies on pediatric fungemia (10-40%) [7][8][9][10].…”

“…(YOC), for 14.3%, higher proportions than in other groups of children with fungemia [6,7,9,10]. This shift in etiology may be caused by more frequent use of azoles in prophylaxis and empiric therapy among children with cancer in comparison with neonates or children after surgery (receiving more nystatin and ketoconazol), in whom C. albicans etiology is predominant [6,9,10]. NAC represented only about 15% in neonates and was even less frequent than in HIV-positive children [7].…”

“…Some papers on pediatric fungemia have focused on neonates, among whom candidemia is an emerging infection [9,10]. Here we report a group of 35 fungemia cases occurring within 10 years in children with cancer and compare them with 130 cases of fungemia in adults with cancer that appeared within the same period.…”

Candida tropicalis in a Neonatal Intensive Care Unit: Epidemiologic and Molecular Analysis of an Outbreak of Infection with an Uncommon Neonatal Pathogen

“…on May 7, 2018 by guest http://jcm.asm.org/ the most common species recovered, followed by C. parapsilosis (27). However, the isolation of non-C. albicans Candida spp.…”

Effects of Macrophage Colony-Stimulating Factor on Antifungal Activity of Neonatal Monocytes against<i> Candida albicans</i>

“…The development of serious candidal infections in these hosts has been attributed to prolonged intensive care and the use of broad-spectrum antibiotics in combination with their immature immune functions [5][6][7][8]. In a prospective epidemiological study in our institution we found an incidence of 10.8 cases of systemic Candida infections per 1,000 admissions in the neonatal units as compared to 1.3 cases for all the other pediatric departments [9].…”