Journals / Meandros Medical And Dental Journal / 2026 / Volume: 24 Issue: 1

Invasive Candida Infections in Children: Species Distribution, Antifungal Susceptibility, and Risk Factors Associated with Mortality

Zeynep Güleç Köksal(DOKUZ EYLUL UNIVERSITY)
Nurşen Belet(DOKUZ EYLUL UNIVERSITY)
Mahmut Cem Ergon(DOKUZ EYLUL UNIVERSITY)
Ahmet Naci Emecen(DOKUZ EYLUL UNIVERSITY)
Mine Doluca Dereli(DOKUZ EYLUL UNIVERSITY)
Pages
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Publication Date
2023-03-30
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

These data will help us identify patients who are at risk for IC and will guide us in the selection of empirical treatment.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: This study determined the distribution and antifungal susceptibility of Candida species, risk factors, and mortality in invasive candidiasis (IC).
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Key Findings & Data:Materials and Methods: The medical data of the pediatric patients with IC were analyzed retrospectively between September 2014 and September 2018.
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Conclusion & Impact:These data will help us identify patients who are at risk for IC and will guide us in the selection of empirical treatment.
🔬Design:Research Article
📍Scope:2014 Verileri
⚙️Variables:Antifungal susceptibility · amphotericin B · candidaemia

Abstract

Objective: This study determined the distribution and antifungal susceptibility of Candida species, risk factors, and mortality in invasive candidiasis (IC). Materials and Methods: The medical data of the pediatric patients with IC were analyzed retrospectively between September 2014 and September 2018. The first IC episodes were included, and the susceptibility was determined by the microdilution method performed according to The Clinical and Laboratory Standards Institute M27-A3 standards. Kaplan-Meier curves were prepared for survival on the 7th and 30th day after the first positive culture and the curves were compared with the log-rank test. Results: Forty-eight Candida isolates were detected in 45 IC episodes. C. albicans and C. parapsilosis were the most common species (both 41.7%). Fluconazole, caspofungin, and amphotericin B resistance were 38.2%, 3.1%, and 2.9%, respectively. Fluconazole resistance was 73.3% among C. parapsilosis. The most common risk factors were underlying diseases (100%), previous antibiotic use (95.6%), and central venous catheter (73.3%). Six (13.3%) patients were deceased within the 30 days. Patients with neutropenia and dialysis had a higher rate of mortality and lower mean survival times for 7-day and 30-day mortality. Mean survival times for 7-day mortality were lower for the patients who had abdominal surgery (p=0.04). Conclusions: There was high fluconazole resistance in C. parapsilosis, which was 73.3%. Neutropenia, dialysis, and abdominal surgery were associated with a significant increase in mortality. These data will help us identify patients who are at risk for IC and will guide us in the selection of empirical treatment.

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Cite This Article

Köksal, Z. G., Belet, N., Ergon, M. C., Emecen, A. N., Dereli, M. D. (2023). Invasive Candida Infections in Children: Species Distribution, Antifungal Susceptibility, and Risk Factors Associated with Mortality. Meandros Medical And Dental Journal, Volume: 24 Issue: 1. https://doi.org/10.4274/meandros.galenos.2023.05925

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References (22)

  1. Pana ZD, Roilides E, Warris A, Groll AH, Zaoutis T. Epidemiology of Invasive Fungal Disease in Children. J Pediatric Infect Dis Soc 2017; 6(Suppl 1): S3-S11.
  2. Fisher BT, Ross RK, Localio AR, Prasad PA, Zaoutis TE. Decreasing rates of invasive candidiasis in pediatric hospitals across the United States. Clin Infect Dis 2014; 58: 74-7.
  3. Zaoutis TE, Heydon K, Localio R, Walsh TJ, Feudtner C. Outcomes attributable to neonatal candidiasis. Clin Infect Dis 2007; 44: 1187- 93.
  4. Öncü B, Belet N, Emecen AN, Birinci A. Health care-associated invasive Candida infections in children. Med Mycol 2019; 57: 929- 36.
  5. M27-A3 Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeasts; Approved Standard-Third Edition; 2008. Accessed August 24, 2018. www.clsi.org.
  6. Kersun LS, Reilly AF, Ingram ME, Nicholaou MJ, McGowan KL. Antifungal susceptibility against yeasts isolated from pediatric oncology patients. Med Mycol 2008; 46: 337-43.
  7. R: The R Project for Statistical Computing. Accessed January 1, 2020. https://www.r-project.org/
  8. Steinbach WJ, Roilides E, Berman D, Hoffman JA, Groll AH, Bin-Hussain I, et al. Results from a prospective, international, epidemiologic study of invasive candidiasis in children and neonates. Pediatr Infect Dis J 2012; 31: 1252-7.
  9. Neu N, Malik M, Lunding A, Whittier S, Alba L, Kubin C, et al. Epidemiology of candidemia at a Children's hospital, 2002 to 2006. Pediatr Infect Dis J 2009; 28: 806-9.
  10. Zaoutis TE, Greves HM, Lautenbach E, Bilker WB, Coffin SE. Risk factors for disseminated candidiasis in children with candidemia. Pediatr Infect Dis J 2004; 23: 635-41.
  11. Pfaller MA, Diekema DJ. Epidemiology of invasive candidiasis: a persistent public health problem. Clin Microbiol Rev 2007; 20: 133- 63.
  12. Celebi S, Hacimustafaoglu M, Ozdemir O, Ozkaya G. Nosocomial candidaemia in children: results of a 9-year study. Mycoses 2008; 51: 248-57.
  13. Karadag-Oncel E, Kara A, Ozsurekci Y, Arikan-Akdagli S, Cengiz AB, Ceyhan M, et al. Candidaemia in a paediatric centre and importance of central venous catheter removal. Mycoses 2015; 58: 140-8.
  14. Dotis J, Prasad PA, Zaoutis T, Roilides E. Epidemiology, risk factors and outcome of Candida parapsilosis bloodstream infection in children. Pediatr Infect Dis J 2012; 31: 557-60.
  15. Dutta A, Palazzi DL. Candida non-albicans versus Candida albicans fungemia in the non-neonatal pediatric population. Pediatr Infect Dis J 2011; 30: 664-8.
  16. Tissot F, Agrawal S, Pagano L, Petrikkos G, Groll AH, Skiada A, et al. ECIL-6 guidelines for the treatment of invasive candidiasis, aspergillosis and mucormycosis in leukemia and hematopoietic stem cell transplant patients. Haematologica 2017; 102: 433-44.
  17. Wisplinghoff H, Ebbers J, Geurtz L, Stefanik D, Major Y, Edmond MB, et al. Nosocomial bloodstream infections due to Candida spp. in the USA: species distribution, clinical features and antifungal susceptibilities. Int J Antimicrob Agents 2014; 43: 78-81.
  18. Devrim I, Yaman Y, Demirağ B, Oymak Y, Cartı Ö, Özek G, et al. A single center's experience with Candida parapsilosis related long-term central venous access device infections: the port removal decision and its outcomes. Pediatr Hematol Oncol 2014; 31: 435-41.
  19. Kazak E, Akın H, Ener B, Sığırlı D, Özkan Ö, Gürcüoğlu E, et al. An investigation of Candida species isolated from blood cultures during 17 years in a university hospital. Mycoses 2014; 57: 623-9.
  20. Blyth CC, Chen SC, Slavin MA, Serena C, Nguyen Q, Marriott D, et al. Not just little adults: candidemia epidemiology, molecular characterization, and antifungal susceptibility in neonatal and pediatric patients. Pediatrics 2009; 123: 1360-8.
  21. Zaoutis TE, Coffin SE, Chu JH, Heydon K, Zhao H, Greves HM, et al. Risk factors for mortality in children with candidemia. Pediatr Infect Dis J 2005; 24: 736-9.
  22. Benjamin DK Jr, Stoll BJ, Fanaroff AA, McDonald SA, Oh W, Higgins RD, et al. Neonatal candidiasis among extremely low birth weight infants: risk factors, mortality rates, and neurodevelopmental outcomes at 18 to 22 months. Pediatrics 2006; 117: 84-92.