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Risk factors for candidemia in pediatric patients with congenital heart disease

Lucia Garcia-San Miguel1, Javier Cobo, Isabel Martos

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

Infection Control and Hospital Epidemiology
|June 7, 2006
PubMed

Insights

Children with congenital heart disease (CHD) and prolonged antibiotic use or high TISS scores are at increased risk for candidemia. Early antifungal treatment and surveillance cultures can improve management of these critical pediatric patients.

Area of Science:

  • Pediatric Intensive Care
  • Infectious Diseases
  • Cardiology

Background:

  • Candidemia poses a significant risk to pediatric patients with congenital heart disease (CHD).
  • Identifying specific risk factors is crucial for effective clinical management in this vulnerable population.

Purpose of the Study:

  • To determine the primary risk factors associated with candidemia acquisition in children diagnosed with congenital heart disease (CHD).
  • To enhance the clinical strategies for managing candidemia in pediatric patients with CHD.

Main Methods:

  • A case-control study was conducted.
  • Data were collected from a tertiary-care referral center in Spain, focusing on patients admitted to the pediatric intensive care unit (PICU) between 1995 and 2000.
  • Case patients had candidemia, while control patients did not, with all participants having CHD.

Main Results:

  • Younger age, longer PICU stays, and prior isolation of Candida species from non-blood specimens were significantly associated with candidemia.
  • Higher Therapeutic Intervention Scoring System (TISS) scores at one week post-PICU admission were independently linked to candidemia.
  • Prolonged antibiotic treatment (over 5 days) emerged as a strong independent predictor for candidemia development.

Conclusions:

  • Children with CHD presenting with high TISS scores and those receiving extended antibiotic therapy are identified as high-risk groups for candidemia.
  • Recommendations include shortening antibiotic courses, implementing routine Candida surveillance cultures, and considering preemptive or empirical antifungal treatments.
Abstract

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