An Update on the Epidemiology of Candidemia in Children

Candidemia is a cause of significant morbidity and mortality in neonates and children. Risk factors for candidemia include prolonged stay in the intensive care unit, prior antibiotic therapy, immunosuppression related to malignancy, transplantation, use of immunosuppressants or steroids, neutropenia, need for mechanical ventilation, use of vasopressors, recent surgery (especially gastrointestinal), intravenous catheters and receipt of total parenteral nutrition. Candida albicans followed by C. parapsilosis are the most common species causing candidemia in children. Clinicians must be aware of the risk factors for candidemia and the local epidemiology of Candida species in order to direct antifungal therapy appropriately. Ongoing efforts to minimize health care-associated candidemia through infection control practices, judicious antimicrobial use and antifungal prophylaxis in appropriate situations are important to reducing Candida-associated morbidity and mortality in neonates and children.