Invasive candidiasis in pediatric intensive care in Greece: a nationwide study

Area of Science:

• Pediatric critical care medicine
• Infectious diseases
• Epidemiology

Background:

• Invasive candidiasis is a significant concern in pediatric intensive care units (PICUs).
• Understanding national epidemiology and management practices is crucial for improving patient outcomes.
• Limited data exists on invasive candidiasis in critically ill children in Greece.

Purpose of the Study:

• To document prevention and management strategies for invasive candidiasis in Greek PICUs.
• To investigate the nationwide epidemiology of candidiasis and its outcomes in critically ill children.
• To identify variations in clinical practices and treatment approaches.

Main Methods:

• A multicenter national study conducted across all seven Greek PICUs.
• A questionnaire survey on local prevention and management practices.
• A retrospective analysis of candidemia episodes over a 5-year period (2005-2009).

Main Results:

• Similar clinical practices in surveillance, catheter care, and antibiotic use were observed, despite differing patient populations.
• Prophylactic antifungal treatment was standard for transplant and neutropenic oncology patients.
• Twenty-two candidemia cases were recorded nationally (incidence 6.4/1,000 admissions), with Candida albicans (45.4%) and Candida parapsilosis (22.7%) as common pathogens.
• Central venous/urinary catheters, mechanical ventilation, and prior antibiotic use were frequent findings.
• Lipid amphotericin B was the primary treatment (54.5%), with a 30-day mortality rate of 18.2%.

Conclusions:

• This study provides the first national data on candidemia epidemiology in critically ill Greek children.
• Candidemia in this population exhibits a relatively low incidence.
• A trend towards non-albicans Candida species predominance was observed.