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Risk factors for candidemia mortality in hospitalized children

Fabio Araujo Motta1, Libera Maria Dalla-Costa2, Marisol Dominguez Muro2

  • 1Hospital Pequeno Príncipe, Curitiba, PR, Brazil; Faculdades Pequeno Príncipe, Curitiba, PR, Brazil; Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, PR, Brazil.

Jornal De Pediatria
|October 8, 2016
PubMed

Insights

Pediatric bloodstream infections caused by Candida species have a high mortality rate (32%). Sepsis, septic shock, acute renal insufficiency, mechanical ventilation, and dialysis are significant risk factors. Low antifungal resistance was observed.

Area of Science:

  • Medical Mycology
  • Pediatric Infectious Diseases
  • Critical Care Medicine

Background:

  • Bloodstream infections caused by Candida species (candidemia) pose a significant threat to hospitalized pediatric patients.
  • Understanding risk factors for mortality and antifungal resistance is crucial for effective management.

Purpose of the Study:

  • To identify risk factors associated with mortality in pediatric patients with candidemia.
  • To evaluate the antifungal resistance patterns of Candida species in this population.

Main Methods:

  • A cross-sectional, observational, analytical study with retrospective data collection.
  • Inclusion of 65 hospitalized pediatric patients diagnosed with bloodstream infections caused by Candida species.
  • Univariate analysis to determine associations between patient characteristics and mortality.

Main Results:

  • The incidence of candidemia was 0.23 cases per 1000 patient-days, with a mortality rate of 32%.
  • Sepsis, septic shock, acute renal insufficiency, mechanical ventilation, and dialysis were significantly associated with increased mortality (p<0.05).
  • Low rates of resistance (4.2%) and dose-dependent susceptibility (2.1%) to fluconazole were observed; no resistance to amphotericin B or echinocandin.

Conclusions:

  • Sepsis, septic shock, acute renal insufficiency, mechanical ventilation, and dialysis are key risk factors for mortality in pediatric candidemia.
  • Candidemia in pediatric patients carries a high mortality rate, irrespective of the Candida species.
  • The study highlights a low prevalence of antifungal resistance, with fluconazole showing minimal resistance and no resistance to amphotericin B or echinocandins.
Abstract

Keywords:
Blood cultureBloodstream infectionCandidemiaHemoculturaInfecção da corrente sanguíneaMortalidade pediátricaPediatric mortality

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