Recent changes in candidemia trends in a tertiary hospital (2011–2018) |
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| Institution: | 1. Pediatric Infectious Diseases, University & Polytechnic Hospital La Fe, Valencia, Spain;2. Health Research Institute La Fe, Valencia, Spain;3. Infectious Diseases, Georgetown University, Washington DC, USA;4. Division of Neonatology, University & Polytechnic Hospital La Fe, Spain;5. Pediatric Intensive Care Unit, University & Polytechnic Hospital La Fe, Spain;6. Microbiology Department, University & Polytechnic Hospital La Fe, Spain;1. Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Perú;2. Hospital Cayetano Heredia, Lima, Perú;3. Instituto de Ciencias Biomédicas (ICBM), Facultad de Medicina Universidad de Chile, Santiago, Chile;4. Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas (CSIC)/Universidad de Sevilla y CIBER de Epidemiología y Salud Pública, Sevilla, España;1. Fungal and Bacterial Biomics Research Group, Department of Immunology, Microbiology and Parasitology, Faculty of Science and Technology, University of the Basque Country (UPV/EHU), Leioa, Spain;2. Mycology Unit, Medical School and IISPV, Universitat Rovira i Virgili, Reus, Spain;3. Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center, Memphis, TN, USA;1. Center of Infectious Diseases, West China Hospital, Sichuan University, 37, Guoxuexiang, 610041 Chengdu, China;2. Department of Laboratory Medicine, West China Hospital, Sichuan University, 610041 Chengdu, China;1. Dermatology Department, Hospital Regional Universitario de Málaga, Spain;2. Microbiology Department, Hospital Regional Universitario de Málaga, Spain;1. Servicio de Microbiología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain;2. Servicio de Neumología, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain;3. Servicio de Anatomía Patológica, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain;4. Departamento de Ciencias Clínicas, Área de Microbiología, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain |
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| Abstract: | BackgroundThe epidemiology of candidemia has changed over the last decades and varies widely among geographic areas.AimsWe examined in children (aged 0–14) with candidemia the trends in the incidence rate of this infection, as well as the clinical characteristics of the patients, in order to optimize the prognosis and the control measures of this serious disease.MethodsA retrospective cohort study of candidemia in the period 2011–2018 in the neonatal intensive care unit (NICU), pediatric ICU (PICU) and pediatric wards of a tertiary hospital, was conducted. The clinical course, Candida species isolated, antifungal susceptibility, outcome and incidence rates were analyzed and compared.ResultsWe diagnosed 68 episodes of candidemia in 62 children, 48% occurred in the NICU, 31% in the PICU and 21% in pediatric wards. Candida albicans was the most frequent species isolated in NICU infants (53%), and Candida parapsilosis predominated among PICU patients (59%) and pediatric wards (50%). One third of NICU infants had invasive candidiasis (IC), most of them having extremely low birth weight (ELBW) (35%). All isolates were susceptible to the antifungal administered. Over time, the incidence of candidemia decreased in the PICU (from 2.2 to 0.3 episodes/1000 patient-days, OR = 0.6; 95%CI 0.5–0.8), whereas in the NICU and in the wards remained stable. Mortality occurred mostly in NICU patients (26%), predominated in ELBW infants and did not change over time.ConclusionsThe higher incidence and mortality of candidemia and IC observed in preterm infants requires a continuous evaluation of practices and diagnostic methods which will allow improving the prognosis of this most vulnerable population. |
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| Keywords: | Candidemia Invasive candidiasis Antifungal agents Epidemiology Candidemia Candidiasis invasora Agentes antifúngicos Epidemiología |
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