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Changing Epidemiology of Invasive Candidiasis in Children during a 10-Year Period
Candida species are a common cause of invasive infection in neonates and children. The aim of our study was to evaluate the epidemiology and microbiology of invasive candidiasis (IC) in the largest tertiary Greek pediatric hospital during a 10-year period. A retrospective cohort study was performed...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6462917/ https://www.ncbi.nlm.nih.gov/pubmed/30813283 http://dx.doi.org/10.3390/jof5010019 |
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author | Noni, Maria Stathi, Angeliki Vaki, Ilia Velegraki, Aristea Zachariadou, Levantia Michos, Athanasios |
author_facet | Noni, Maria Stathi, Angeliki Vaki, Ilia Velegraki, Aristea Zachariadou, Levantia Michos, Athanasios |
author_sort | Noni, Maria |
collection | PubMed |
description | Candida species are a common cause of invasive infection in neonates and children. The aim of our study was to evaluate the epidemiology and microbiology of invasive candidiasis (IC) in the largest tertiary Greek pediatric hospital during a 10-year period. A retrospective cohort study was performed from January 2008 to December 2017. Identification of species and antifungal susceptibility testing was performed according to the Clinical and Laboratory Standards Institute (CLSI) methodology. During the study period, 178 cases of IC were recorded. The tissue distribution included blood (87.1%), cerebrospinal (7.9%), peritoneal (3.9%) and pleural fluids (1.1%). Candida albicans and Candida parapsilosis (sensu lato) were the most frequently isolated species (47.8% and 28.7% respectively). From period 2008–2012 to period 2013–2017, a significant decrease in IC rates was detected (0.21 cases/1000 hospitalization days VS 0.11 cases/1000 hospitalization days, P = 0.040), while median minimum inhibitory concentrations (MICs) of amphotericin B were significantly increased for both C. albicans and C. parapsilosis (sl) (P = 0.037 and P = 0.004 respectively). The decrease in IC rates may reflect the increased awareness as well as the effective infection control initiatives and antifungal interventions. However, the significant increase in the MICs for amphotericin B and echinocandins such as caspofungin, raises concerns about their common use as first-line treatment. Epidemiologic monitoring is, therefore, critically important in order to evaluate and optimize therapeutic protocols for IC in pediatric populations. |
format | Online Article Text |
id | pubmed-6462917 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-64629172019-04-17 Changing Epidemiology of Invasive Candidiasis in Children during a 10-Year Period Noni, Maria Stathi, Angeliki Vaki, Ilia Velegraki, Aristea Zachariadou, Levantia Michos, Athanasios J Fungi (Basel) Article Candida species are a common cause of invasive infection in neonates and children. The aim of our study was to evaluate the epidemiology and microbiology of invasive candidiasis (IC) in the largest tertiary Greek pediatric hospital during a 10-year period. A retrospective cohort study was performed from January 2008 to December 2017. Identification of species and antifungal susceptibility testing was performed according to the Clinical and Laboratory Standards Institute (CLSI) methodology. During the study period, 178 cases of IC were recorded. The tissue distribution included blood (87.1%), cerebrospinal (7.9%), peritoneal (3.9%) and pleural fluids (1.1%). Candida albicans and Candida parapsilosis (sensu lato) were the most frequently isolated species (47.8% and 28.7% respectively). From period 2008–2012 to period 2013–2017, a significant decrease in IC rates was detected (0.21 cases/1000 hospitalization days VS 0.11 cases/1000 hospitalization days, P = 0.040), while median minimum inhibitory concentrations (MICs) of amphotericin B were significantly increased for both C. albicans and C. parapsilosis (sl) (P = 0.037 and P = 0.004 respectively). The decrease in IC rates may reflect the increased awareness as well as the effective infection control initiatives and antifungal interventions. However, the significant increase in the MICs for amphotericin B and echinocandins such as caspofungin, raises concerns about their common use as first-line treatment. Epidemiologic monitoring is, therefore, critically important in order to evaluate and optimize therapeutic protocols for IC in pediatric populations. MDPI 2019-02-22 /pmc/articles/PMC6462917/ /pubmed/30813283 http://dx.doi.org/10.3390/jof5010019 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Noni, Maria Stathi, Angeliki Vaki, Ilia Velegraki, Aristea Zachariadou, Levantia Michos, Athanasios Changing Epidemiology of Invasive Candidiasis in Children during a 10-Year Period |
title | Changing Epidemiology of Invasive Candidiasis in Children during a 10-Year Period |
title_full | Changing Epidemiology of Invasive Candidiasis in Children during a 10-Year Period |
title_fullStr | Changing Epidemiology of Invasive Candidiasis in Children during a 10-Year Period |
title_full_unstemmed | Changing Epidemiology of Invasive Candidiasis in Children during a 10-Year Period |
title_short | Changing Epidemiology of Invasive Candidiasis in Children during a 10-Year Period |
title_sort | changing epidemiology of invasive candidiasis in children during a 10-year period |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6462917/ https://www.ncbi.nlm.nih.gov/pubmed/30813283 http://dx.doi.org/10.3390/jof5010019 |
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