Predicting Candida Infection in Pediatric Intensive Care Unit using Candida Score in a Low-Resource Setting

Area of Science:

• Pediatric Intensive Care
• Infectious Diseases
• Critical Care Medicine

Background:

• Candida infections were historically rare in intensive care settings but have increased with broad-spectrum antibiotic use.
• The incidence of fungal infections in pediatric intensive care units (PICUs) requires further investigation for effective management.

Purpose of the Study:

• To evaluate the Candida score as a predictor of Candida infection in patients within a Pediatric Intensive Care Unit (PICU).
• To determine the diagnostic accuracy and predictive value of the Candida score in a pediatric critical care population.

Main Methods:

• A case-control study was conducted involving pediatric patients (≤18 years) admitted for at least three days to the PICU.
• Data were collected from January 2014 to December 2016, comparing 43 children with positive Candida cultures (cases) to 43 without (controls).
• The predictive performance of a Candida score cutoff of ≥3 was assessed using Area Under the Curve (AUC) and Odds Ratio (OR).

Main Results:

• A Candida score cutoff of ≥3 demonstrated moderate predictive accuracy (AUC = 0.72).
• Patients with a Candida score ≥3 had a significantly higher risk of Candida infection (OR = 6.8, P < 0.05).
• Confounding factors commonly associated with Candida infection showed no significant association (P > 0.05) in this cohort.

Conclusions:

• The Candida score is a valuable and independent predictor of Candida infection in the Pediatric Intensive Care Unit (PICU).
• Implementing the Candida score can aid clinicians in identifying high-risk pediatric patients for timely antifungal treatment and improved outcomes.