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Candidemia in pediatric patients with congenital heart disease

Lucía García San Miguel1, Javier Cobo, Enrique Otheo

  • 1Infectious Diseases Department, Ramon y Cajal Hospital, 28034 Madrid, Spain. lgarcias.hrc@salud.madrid.org

Diagnostic Microbiology and Infectious Disease
|March 21, 2006
PubMed

Insights

Candidemia, a serious bloodstream infection, is common in pediatric patients with congenital heart disease (CHD). While mortality is high, it

Area of Science:

  • Pediatric Infectious Diseases
  • Cardiology

Background:

  • Candidemia poses a significant challenge in pediatric care.
  • Congenital heart disease (CHD) patients exhibit the highest rates of candidemia in our hospital.
  • Understanding candidemia's clinical and mortality features in this vulnerable population is crucial.

Purpose of the Study:

  • To describe the clinical characteristics and mortality patterns of candidemia in pediatric patients with CHD.
  • To identify factors associated with mortality in this cohort.

Main Methods:

  • Retrospective case series analysis of 52 pediatric patients with candidemia and CHD from 1988 to 2000.
  • Data collection included patient demographics, treatment, causative Candida species, and outcomes.
  • Statistical analysis identified independent predictors of mortality.

Main Results:

  • The study included very young infants (median age, 2 months) often receiving prolonged antibiotic therapy (median, 20.5 days).
  • Candida parapsilosis was the predominant species (54%).
  • In-hospital mortality was 39%, with 14% attributed to candidemia. Catheter maintenance and patient severity (Pediatric Risk Score of Mortality I) were associated with mortality.

Conclusions:

  • Candidemia in pediatric CHD patients often affects very young infants and is linked to prolonged antibiotic use.
  • While overall mortality is high, candidemia is not always the direct cause of death.
  • Optimal management strategies include ruling out endocarditis, prompt antifungal treatment, and considering catheter removal.

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