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Persistent candidemia in pediatrics: exploring risk factors

Adriele C Siqueira1, Amanda M M Ferreira2, Stella C S B Silva3

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

Jornal De Pediatria
|March 20, 2026
PubMed

Insights

Persistent candidemia (PC) in children is linked to central venous catheters, parenteral nutrition, and cancer. Early monitoring of pediatric patients is crucial for better outcomes in invasive fungal infections.

Area of Science:

  • Pediatric Infectious Diseases
  • Mycology
  • Clinical Microbiology

Background:

  • Persistent candidemia (PC) in children is a serious condition with significant morbidity and mortality.
  • Risk factors and clinical impact of pediatric PC are not well-defined.
  • Understanding these factors is crucial for improving patient management.

Purpose of the Study:

  • To identify independent risk factors associated with persistent candidemia in pediatric patients.
  • To analyze the clinical impact and outcomes of PC in children.
  • To investigate the characteristics of Candida isolates from pediatric candidemia cases.

Main Methods:

  • Retrospective analysis of 141 pediatric patients (0-17 years) with candidemia.
  • Data collection included clinical information, central venous catheter presence, parenteral nutrition, and cancer history.
  • Microbial identification (MALDI-TOF MS), biofilm production, antifungal susceptibility, molecular typing, and ERG11 mutation screening were performed.

Main Results:

  • Persistent candidemia occurred in 34.8% of patients.
  • Independent risk factors for PC included central venous catheter, parenteral nutrition, and cancer.
  • Overall 30-day mortality was 23.4%, with candidemia-related mortality at 16.3%.
  • Candida parapsilosis was the most common species; most isolates produced biofilm.
  • One fluconazole-resistant Candida tropicalis isolate had an ERG11 Y257H mutation.

Conclusions:

  • Persistent candidemia in children is associated with host factors and clinical management strategies.
  • Early removal of central venous catheters and vigilant patient monitoring are critical.
  • The etiological agent's characteristics played a lesser role compared to patient-specific factors.
Abstract

Keywords:
ChildrenHost characteristicsInvasive candidiasisMortalityPersistent candidemiaRisk factor

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