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Invasive Candidiasis in Pediatric Patients at King Fahad Medical City in Riyadh, Saudi Arabia: A 5-year Retrospective Study

BACKGROUND: Invasive candidiasis in children is associated with high morbidity and mortality. We aim to identify predisposing factors, species distribution, antifungal susceptibility, and outcomes among patients with candidemia. METHODS: A data collection form composed of seven sections including 51...

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Detalles Bibliográficos
Autor principal: Almoosa, Zainab
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5631081/
http://dx.doi.org/10.1093/ofid/ofx163.1610
Descripción
Sumario:BACKGROUND: Invasive candidiasis in children is associated with high morbidity and mortality. We aim to identify predisposing factors, species distribution, antifungal susceptibility, and outcomes among patients with candidemia. METHODS: A data collection form composed of seven sections including 51 questions was designed to gather demographic and clinical information. We collected data from all 129 patients with invasive candidiasis from January 2010 to January 2015. RESULTS: The 129 patients had the following risk factors: 30 (23.26%) were premature, 34 (26.36%) had low birth weight, 59 (45.74%) had a central venous catheter, 21 (16.28%) had a malignancy, 20 (15.5%) received immunotherapy, and 56 (43.41%) received ventilator support. A multivariate analysis revealed a more than two-fold mortality rate in patients who had vegetation in the heart (OR 2.9), and patients who had Candida isolated from their blood were more than twice as likely to die as patients with Candida isolated from other sites (OR 2.2). A total of 48.33% of patients on ventilator support died, and 26.09% of patients who were not on ventilator support died (P = 0.009); 43.75% of patients in the intensive care unit (ICU) died vs. only 24.49% of patients who were not in the ICU (P = 0.03). C. parapsilosis exhibited the highest mortality rate among all Candida species (56.2%). CONCLUSION: The study revealed that C. albicans was the most common isolate among all Candida species. Mechanical ventilation and an ICU stay were significant risk factors for death in children with invasive candidiasis. DISCLOSURES: All authors: No reported disclosures.