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Candidemia in a pediatric population

J K Stamos1, A H Rowley

  • 1Department of Pediatrics, Loyola University Medical Center, Maywood, Illinois 60135, USA.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|March 1, 1995
PubMed
Summary

Pediatric candidemia has lower mortality than in adults. Prompt removal of central venous catheters significantly improves survival, and amphotericin B is well-tolerated in children.

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Area of Science:

  • Pediatric Infectious Diseases
  • Mycology
  • Critical Care Medicine

Background:

  • Candidemia poses a significant mortality risk in adults, yet pediatric data remain limited.
  • Candida species are a common cause of bloodstream infections in neonates and children.
  • Understanding risk factors and outcomes in pediatric candidemia is crucial for effective management.

Purpose of the Study:

  • To analyze the epidemiology, clinical features, and outcomes of pediatric candidemia.
  • To identify factors associated with mortality in children with candidemia.
  • To evaluate the efficacy and tolerability of antifungal therapy in pediatric patients.

Main Methods:

  • Retrospective review of 70 pediatric candidemia episodes from January 1988 to October 1992.
  • Analysis of causative Candida species, patient demographics, underlying conditions, and treatment modalities.
  • Assessment of the impact of central venous catheter management and antifungal therapy on patient outcomes.

Main Results:

  • Candida albicans was the most common species (53%), followed by C. parapsilosis (24%) and C. tropicalis (16%).
  • Premature infants and patients with malignancy, cardiac disease, or short-gut syndrome were frequently affected.
  • Mortality rate was 19%; catheter removal within 3 days was associated with significantly better survival (P < .0001).
  • Amphotericin B was used in 74% of treated patients and was well-tolerated; 17 immunocompetent patients survived without antifungal treatment.

Conclusions:

  • Pediatric candidemia has a lower mortality rate compared to adults.
  • Timely removal of central venous catheters is critical for improving survival in pediatric candidemia.
  • Candiduria is an infrequent precursor to candidemia in children.
  • Amphotericin B demonstrates good tolerability and efficacy in treating pediatric candidemia.

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