The Epidemiology of Neonatal and Pediatric Candidemia in England and Wales, 2000–2009

Oeser, Clarissa; Lamagni, Theresa; Heath, Paul T; Ladhani, Shamez

doi:10.1097/inf.0b013e318275612e

Cited by 38 publications

(52 citation statements)

References 30 publications

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“…4,5,7 A 4.9% candidemia incidence was documented in the neonatal intensive care unit. This was higher than in the study conducted by Celebi S et al and Jinjian Fu et al where the incidence documented was 1.1%.…”

Section: Discussionmentioning

confidence: 99%

“…Candida species was reported in 89.6% (1320/1473) cases of fungal sepsis, with Candida albicans and Candida parapsilosis accounting for most infections in all age groups. 7 Lee JH et al: has studied on Risk factors for invasive candidiasis in infants >1500 g birth weight in the Department of Pediatrics, Duke University Medical Center, Durham, NC, USA. They concluded that Invasive candidiasis is uncommon in infants >1500 g birth weight.…”

Section: Introductionmentioning

confidence: 99%

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Clinical profile of neonatal candidiasis in newborn nursery

James

Anuja

Ninan

2018

Int J Contemp Pediatr

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Background: Candidiasis refers to infection with fungi of the genus candida. Candida infections are frequent and major causes of septicemia in neonatal intensive care units and are associated with high morbidity and mortality. Low birth weight preterm infants are especially vulnerable to these devastating infections. Candida infections are a major cause of septicemia in neonatal ICUs and may affect 1.6% to 12.9% of very low birth weight infants. The smaller the infant is, the greater is the likelihood for systemic fungal infection to develop.Methods: 40 Newborns with culture proven candidiasis admitted in new-born nursery of Government T. D Medical College, Alappuzha, were selected for the study. The significance of different parameters such as gender, gestational age, birth weight, Apgar score, duration of hospital stays, central venous catheter and use of third generation cephalosporins were analysed. Clinical profile like apnoea, feed intolerance, requirement of ventilator support, temperature instability, thrombocytopenia, hyperglycemia etc. were analyzed.Results: Out of 40 newborns 39 were preterms, 42% of study population were having a birth weight of 1-1.5 kg, 33% with a birth weight of 1.5-2 kg and 20% with a birth weight of <1 kg.75% of the study population were hospitalized for >1 week. In the study group 58% had feed intolerance, 52.5% needed ventilator support, 52.5% had temperature instability, 70% had thrombocytopenia 50% had apnea and 4% had hyperglycemia. The overall survival was 60%.Conclusions: Prematurity, low birth weight and prolonged hospital stay were associated with increased risk of candidiasis. Feed intolerance, increased need for ventilator support, apnea, temperature instability and thrombocytopenia were significant clinical parameters.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical profile of neonatal candidiasis in newborn nursery

James

Anuja

Ninan

2018

Int J Contemp Pediatr

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“…Although Candida albicans has long been the most common cause of candidemia infections obtained from neonatal intensive care units (NICUs) [3, 4]. Non-C.albicans species such as Candida glabrata (C.glabrata) , Candida tropicalis (C.tropicalis) , Candida parapsilosis ( C.parapsilosis ) and Candida krusei ( C.krusei ) have emerged as the second or even the predominant pathogens that caused neonatal candidemia in some local hospitals [5].…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of Candida albicans and non-C.albicans of neonatal candidemia at a tertiary care hospital in western China

Ding

et al. 2017

BMC Infect Dis

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BackgroundAlthough the majority of Candida infections occur in the developing world, candidemia epidemiology is poorly understood in these countries. The aim of this study was to investigate the epidemiology of non-Candida albicans (non-C. albicans) candidemia among neonates at Liuzhou Maternity and Child Healthcare Hospital in China.MethodsA retrospective review of all positive blood culture about Candida species in neonatal intensive care unit was conducted between January 2012 and November 2015. Information about demographics, risk factors and outcome of candidemia were collected. Univariate and multivariate logistic regression models were used to identify the risk factors associated with the development of non-C.albicans candidemia.ResultsThe prevalence of candidemia in infants was 1.4%. Non-C.albicans was responsible for 56.5% of neonatal candidemia. The predisposing factors for development of non-C.albicans candidemia among infants included mechanical ventilation [odds ratio (OR), 95% confidence interval (95%CI) = 3.13, 1.07–9.14; P = 0.037] and use of assisted reproductive technology (OR, 95%CI = 4.52, 1.39–14.77; P = 0.012). The overall mortality rate of candidemia was 8.7% and non-C.albicans attributed to 83.3% of all mortalities.Conclusions Non-C.albicans species are the major cause of candidemia in local neonatal group. The study highlights the urgent needs to evaluate the possibility of development of non-C.albicans candidemia in neonates exposed to these risk factors and much emphasis must be laid on the early implementation of medical intervention to reduce the incidences of candidemia in neonates.

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“…Candidemia has emerged as an important infection control issue [3,4], because it contributes significantly to morbidity, an increased hospital stay and medical costs [5][6][7]. In children, bloodstream infections (BSIs) caused by Candida mainly occur in pediatric and neonatal intensive care units (ICUs) or patients with underlying hematological/oncologic malignancy, with Candida albicans being the most common cause of Candida infections [8][9][10].…”

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confidence: 99%

Clinical and molecular characteristics of bloodstream infections caused by Candida albicans in children from 2003 to 2011

Tsai

Wang

Hsu

et al. 2015

Clinical Microbiology and Infection

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We investigated the clinical and molecular characteristics of Candida albicans bloodstream infection (BSI) in children from a tertiary-level medical centre in Taiwan over a 9-year period from January 2003 to December 2011. We performed multilocus sequence typing (MLST) to investigate the genetic relatedness of these C. albicans BSI isolates. A total of 79 episodes of C. albicans BSI in 76 paediatric patients were identified, including 41 (51.9%) from the paediatric intensive care unit, 24 (30.4%) from the neonatal intensive care unit and 14 (17.7%) from general wards. More than half (59.5%) of these patients had underlying chronic co-morbidities, and the majority (94.9%) had a catheter or some other artificial device. All the isolates were susceptible to the antifungal agents tested. Only 32.9% (26/79) received effective antifungal agents within 24 h of onset of candidaemia. Twenty-five (31.6%) patients had persistent candidaemia (>3 days after the start of antifungal treatment) and candidaemia-attributable mortality rate was 22.8% (18/79). The 72 isolates available for MLST yielded 53 unique diploid sequence types (DSTs). Forty-five DSTs were singletons and eight DSTs were shared by 27 (37.5%) isolates. Seventy-one (98.6%) isolates were clustered within previously known clades. Based on the definition of two or more strains with shared DST occurring within a period of 90 days, 10.1% of the infections were categorized as nosocomial clusters, most commonly identified in the intensive care units. Although cluster-associated candidaemia was not associated with a higher mortality rate, none of the clusters were identified by the hospital infection control team.

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The Epidemiology of Neonatal and Pediatric Candidemia in England and Wales, 2000–2009

Abstract: Pediatric candidemia rates are beginning to fall in England and Wales. C. albicans continues to account for most Candida bloodstream infections in all age groups with no evidence of increases in non-albicans species.

Cited by 38 publications

References 30 publications

Clinical profile of neonatal candidiasis in newborn nursery

Clinical profile of neonatal candidiasis in newborn nursery

Epidemiology of Candida albicans and non-C.albicans of neonatal candidemia at a tertiary care hospital in western China

Clinical and molecular characteristics of bloodstream infections caused by Candida albicans in children from 2003 to 2011

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