Predicting Candida Infection in Pediatric Intensive Care Unit using Candida Score in a Low-Resource Setting

Risandy, Dicky Ari; Rusmawatiningtyas, Desy; Makrufardi, Firdian; Herini, Elisabeth Siti; Nurnaningsih,

doi:10.1177/2333794x21999152

Cited by 2 publications

(2 citation statements)

References 18 publications

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“…Due to the common use of fluconazole in empiric antifungal prophylaxis in high-risk premature infants, an increased colonization of the gastrointestinal tract with Candida non-albicans was observed. The main pathogens were Candida parapsilosis (increase in all the studied years except 2017) and Candida glabrata in 2019 and 2020, which is in accordance with data published in the literature [8][9][10][11][12][13].…”

Section: Discussionsupporting

confidence: 89%

Fungal Infection Testing in Pediatric Intensive Care Units—A Single Center Experience

Klepacka

Zakrzewska

Czogała

et al. 2022

IJERPH

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Mycoses are diseases caused by fungi that involve different parts of the body and can generate dangerous treatment complications. This study aims to analyze fungal infection epidemiology in intensive care units (Pediatric and Cardiac Surgery Intensive Care Units—PCICU) and the Neonatal Intensive Care Unit (NICU) in one large pediatric center in the period 2015–2020 compared with 2005. The year 2005 was randomly selected as a historical time reference to notice possible changes. In 2005 and 2015–2020, 23,334 mycological tests were performed in intensive care units. A total of 4628 tests (19.8%) were performed in the intensive care units. Microbiological diagnostics involved mycological and serological testing. Of the 458 children hospitalized in the NICU, positive results in the mycological tests in the studied years were found in 21–27% of the children and out of 1056 PCICU patients, positive results were noticed in 18–29%. In both departments, the main detected pathogen was Candida albicans which is comparable with data published in other centers. Our experience indicates that blood cultures as well as the detection of antifungal antibodies do not add important information to mycological diagnostics. For the years of observation, only a few positive results were detected, even in patients with invasive fungal diseases. To our knowledge, this is one of a few similar studies over recent years and it provides contemporary reports of mycoses in pediatric ICU patients.

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Section: Discussionsupporting

confidence: 89%

Fungal Infection Testing in Pediatric Intensive Care Units—A Single Center Experience

Klepacka

Zakrzewska

Czogała

et al. 2022

IJERPH

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“…A male predominance in pediatric candidemia cases has been noted in previous studies but was not considered and calculated as a separate independent predictive risk factor. 19,44,45 This variable was significant in our study where 77% of infected children were males. It should be noted, however, that another study reported a female predominance.…”

Section: Risk Factors For Candidemiamentioning

confidence: 61%

Risk Factors and Characteristics of Candidemia After Cardiac Surgery in Pediatric Patients in Central Israel

Kahan¹,

Tope²,

Ovadia

et al. 2023

Pediatric Infectious Disease Journal

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Background: Candidemia is a serious complication in pediatric patients with congenital heart defects (CHD) after cardiac surgery. Information about the epidemiology, clinical characteristics and risk factors for candidemia in this vulnerable population remains limited. Methods: This retrospective case–control study was conducted in 2 pediatric intensive care units between 2004 and 2019. All patients <18 years old who developed candidemia following cardiac surgery were included. Each case was matched with 2 control patients based on age and date of surgery. Multivariable logistic regression analysis was conducted to determine the risk factors for postoperative candidemia. Results: Thirty-five candidemia cases were identified and matched to 70 control cases. The incidence of candidemia was 6.3 episodes per 1000 admissions. The median age for candidemia cases was 4 months. The attributable mortality was 28.5%. The predominant (54%) pathogens isolated were non-albicans Candida species, of which C. parapsilosis isolates demonstrated high resistance to fluconazole (70%). Independent risk factors associated with candidemia included cumulative antibiotic exposure for ≥4 days [OR: −4.3; 95% confidence interval (CI): 1.3–14.6; P = 0.02], the need for total parenteral nutrition or peritoneal dialysis (OR: −6.1; 95% CI: 2–18.8; P = 0.001), male sex (OR: 6.2; 95% CI: 1.9–20.3; P = 0.002) and delayed sternal closure≥2 days (OR: −3.2; 95% CI: 1–11.2; P = 0.05). Conclusions: Postoperative candidemia in children with CHD is an uncommon but severe complication. Our study revealed an unexpectedly high frequency of fluconazole-resistant C. parapsilosis as the main cause of non-albicans candidemia. In addition to confirming previously recognized risk factors, our results reveal new potential risk factors such as delayed sternal closure and male sex.

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Predicting Candida Infection in Pediatric Intensive Care Unit using Candida Score in a Low-Resource Setting

Cited by 2 publications

References 18 publications

Fungal Infection Testing in Pediatric Intensive Care Units—A Single Center Experience

Fungal Infection Testing in Pediatric Intensive Care Units—A Single Center Experience

Risk Factors and Characteristics of Candidemia After Cardiac Surgery in Pediatric Patients in Central Israel

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