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Mortality associated with systemic candidiasis in children

A Pacheco-Ríos1, C Avila-Figueroa, D Nobigrot-Kleinman

  • 1Department of Infectious Diseases, Hospital Infantil de México, Federico Gómez, México, D.F.

Archives of Medical Research
|July 1, 1997
PubMed
Summary

Delayed antifungal treatment significantly increases mortality risk in children with systemic Candida infections. Early empirical therapy is crucial for improving survival rates in pediatric candidemia cases.

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Area of Science:

  • Pediatric Infectious Diseases
  • Mycology
  • Critical Care Medicine

Background:

  • Systemic Candida infections (candidemia) pose a significant mortality risk in hospitalized children.
  • Understanding risk factors for mortality is essential for timely and effective treatment strategies.

Purpose of the Study:

  • To identify factors associated with increased mortality in children hospitalized with systemic Candida infections.
  • To evaluate the impact of treatment delay on survival outcomes in pediatric candidemia.

Main Methods:

  • Retrospective analysis of 71 pediatric cases of Candida bloodstream infections over a 2-year period.
  • Logistic regression analysis was used to assess independent risk factors for death.
  • Comparison of mortality rates between the two study years and different age groups.

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Main Results:

  • The overall case fatality rate for candidemia was 46.5%.
  • Malnutrition (OR=4.3), prior surgery (OR=3.8), and delayed antifungal treatment (OR=1.12 per day) were independently associated with increased mortality.
  • Mortality significantly decreased from 65% in year one to 20% in year two, coinciding with a potential shift in treatment practices.

Conclusions:

  • Delayed initiation of antifungal treatment is a critical, modifiable risk factor for mortality in pediatric candidemia.
  • Empirical antifungal therapy should be considered early in the management of suspected systemic candidiasis in children.
  • These findings underscore the importance of prompt diagnosis and treatment to improve survival outcomes.