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Candidemia in children.

Theoklis Zaoutis1

  • 1Divisionof Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA. Zaoutis@email.chop.edu

Current Medical Research and Opinion
|June 2, 2010
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Summary
This summary is machine-generated.

Seriously ill children face a high risk of invasive fungal infections like candidemia. Early antifungal treatment is crucial, with guidelines recommending specific therapies based on risk factors and disease severity.

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Area of Science:

  • Pediatric Infectious Diseases
  • Mycology
  • Critical Care Medicine

Background:

  • Seriously ill or immunocompromised children are susceptible to invasive fungal infections, primarily candidemia.
  • Candida albicans and Candida parapsilosis are the leading causes of candidemia in pediatric populations.
  • Candidemia in children leads to significant morbidity, mortality, prolonged hospital stays, and increased healthcare costs.

Purpose of the Study:

  • To review current understanding and guidelines for managing candidemia in children.
  • To highlight the importance of early and effective antifungal therapy.
  • To identify risk factors for candidemia to guide empiric therapy and prophylaxis strategies.

Main Methods:

  • Review of existing literature and current clinical guidelines (e.g., Infectious Diseases Society of America).
  • Identification of key risk factors associated with candidemia in pediatric patients.
  • Analysis of recommended empiric and targeted antifungal treatment strategies.

Main Results:

  • Key risk factors for candidemia include ICU stay, immunosuppression, prior bacterial infections, surgery, central venous catheters, mechanical ventilation, and total parenteral nutrition.
  • Guidelines suggest fluconazole or echinocandins for empiric therapy, with echinocandins preferred in certain high-risk scenarios.
  • Treatment recommendations vary for neutropenic versus non-neutropenic candidemia, with echinocandins or lipid amphotericin B often favored for neutropenic cases.

Conclusions:

  • Early antifungal therapy is critical for improving outcomes in pediatric candidemia.
  • Established risk factors aid in identifying children who may benefit from empiric treatment.
  • Further research is needed to refine antifungal prophylaxis criteria, especially in older children.