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Fungal Infection Testing in Pediatric Intensive Care Units-A Single Center Experience
Joanna Klepacka1, Zuzanna Zakrzewska2, Małgorzata Czogała2,3
1Department of Microbiology, University Children's Hospital, Wielicka 265, 30-663 Krakow, Poland.
Abstract:
Mycoses are diseases caused by fungi that involve different parts of the body and can generate dangerous treatment complications. This study aims to analyze fungal infection epidemiology in intensive care units (Pediatric and Cardiac Surgery Intensive Care Units-PCICU) and the Neonatal Intensive Care Unit (NICU) in one large pediatric center in the period 2015-2020 compared with 2005. The year 2005 was randomly selected as a historical time reference to notice possible changes. In 2005 and 2015-2020, 23,334 mycological tests were performed in intensive care units. A total of 4628 tests (19.8%) were performed in the intensive care units. Microbiological diagnostics involved mycological and serological testing. Of the 458 children hospitalized in the NICU, positive results in the mycological tests in the studied years were found in 21-27% of the children and out of 1056 PCICU patients, positive results were noticed in 18-29%. In both departments, the main detected pathogen was Candida albicans which is comparable with data published in other centers. Our experience indicates that blood cultures as well as the detection of antifungal antibodies do not add important information to mycological diagnostics. For the years of observation, only a few positive results were detected, even in patients with invasive fungal diseases. To our knowledge, this is one of a few similar studies over recent years and it provides contemporary reports of mycoses in pediatric ICU patients.
Insights
Fungal infections (mycoses) are common in pediatric intensive care units, with Candida albicans being the primary pathogen. Diagnostic methods like blood cultures and antibody detection offer limited value for these critical cases.
Area of Science:
- Medical Mycology
- Infectious Diseases Epidemiology
Background:
- Mycoses pose significant treatment challenges in pediatric intensive care settings.
- Understanding the epidemiology of fungal infections is crucial for effective management.
Purpose of the Study:
- To analyze the epidemiology of fungal infections in Neonatal Intensive Care Unit (NICU) and Pediatric and Cardiac Surgery Intensive Care Units (PCICU).
- To compare current fungal infection rates (2015-2020) with a historical reference year (2005).
Main Methods:
- Retrospective analysis of mycological and serological tests performed in ICUs between 2005 and 2020.
- Inclusion of data from 458 NICU patients and 1056 PCICU patients.
Main Results:
- Positive fungal tests were observed in 21-27% of NICU patients and 18-29% of PCICU patients.
- Candida albicans was the predominant pathogen identified in both units.
- Blood cultures and antifungal antibody detection provided minimal additional diagnostic information.
Conclusions:
- Fungal infection rates in pediatric ICUs remain a concern, with Candida albicans consistently identified.
- Current diagnostic approaches may require refinement, as traditional methods showed limited utility.
