Candida spp bloodstream infections in a Latin American Pediatric Oncology Reference Center: Epidemiology and associated factors.
Adolescent
Age Factors
Brazil
/ epidemiology
Candida
/ isolation & purification
Candidemia
/ diagnosis
Candidiasis
/ diagnosis
Child
Child, Preschool
Female
Humans
Immunosuppression Therapy
Infant
Intensive Care Units
Invasive Fungal Infections
/ diagnosis
Male
Medical Oncology
Mortality
Neoplasms
/ complications
Prognosis
Retrospective Studies
Risk Factors
Sepsis
/ diagnosis
Thrombocytopenia
Candida albicans
Candidaemia
Non-albicans Candida
bloodstream infections
children
immunosuppression
invasive fungal disease
oncology
Journal
Mycoses
ISSN: 1439-0507
Titre abrégé: Mycoses
Pays: Germany
ID NLM: 8805008
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
received:
13
01
2020
revised:
11
05
2020
accepted:
13
05
2020
pubmed:
20
5
2020
medline:
10
4
2021
entrez:
20
5
2020
Statut:
ppublish
Résumé
Invasive fungal disease is a significant cause of morbidity and mortality in immunosuppressed children. The recognition of patients at risk for candidaemia is paramount to a better prognosis. To characterize Candida spp bloodstream infections (BSI) in a reference centre for paediatric oncology and to describe the most prevalent risk factors associated with candida infections. This is a retrospective cohort study carried out with paediatric patients followed up with at the Institute of Pediatric Oncology, Brazil, who presented positive blood culture for Candida spp from January 2004 to December 2016. Ninety episodes of candidaemia were analysed; patients had a median age of 4.5 years, and 57.8% were males, with a diagnosis of solid tumours in 54.5% of cases. The most common Candida species were C albicans (35.6%), C parapsilosis (30.0%) and C tropicalis (16.7%). C tropicalis BSI was associated with neutropenia and skin lesions. Therapy was successful in 67.1% of the episodes. Older age and thrombocytopenia were associated with therapeutic failure. Death within 30 days occurred in 24.4% of patients; predictive factors were older age and admission to an ICU C parapsilosis candidaemia was a protective factor for death when compared to C albicans. The main species isolated were C albicans, C parapsilosis and C tropicalis. C tropicalis BSI was associated with neutropenia and skin lesions. The death rate was significant, and a worse prognosis was associated with older age, thrombocytopenia and admission to an ICU C parapsilosis infection proved to be a protective factor against mortality.
Sections du résumé
BACKGROUND
BACKGROUND
Invasive fungal disease is a significant cause of morbidity and mortality in immunosuppressed children. The recognition of patients at risk for candidaemia is paramount to a better prognosis.
OBJECTIVES
OBJECTIVE
To characterize Candida spp bloodstream infections (BSI) in a reference centre for paediatric oncology and to describe the most prevalent risk factors associated with candida infections.
PATIENTS/METHODS
METHODS
This is a retrospective cohort study carried out with paediatric patients followed up with at the Institute of Pediatric Oncology, Brazil, who presented positive blood culture for Candida spp from January 2004 to December 2016.
RESULTS
RESULTS
Ninety episodes of candidaemia were analysed; patients had a median age of 4.5 years, and 57.8% were males, with a diagnosis of solid tumours in 54.5% of cases. The most common Candida species were C albicans (35.6%), C parapsilosis (30.0%) and C tropicalis (16.7%). C tropicalis BSI was associated with neutropenia and skin lesions. Therapy was successful in 67.1% of the episodes. Older age and thrombocytopenia were associated with therapeutic failure. Death within 30 days occurred in 24.4% of patients; predictive factors were older age and admission to an ICU C parapsilosis candidaemia was a protective factor for death when compared to C albicans.
CONCLUSION
CONCLUSIONS
The main species isolated were C albicans, C parapsilosis and C tropicalis. C tropicalis BSI was associated with neutropenia and skin lesions. The death rate was significant, and a worse prognosis was associated with older age, thrombocytopenia and admission to an ICU C parapsilosis infection proved to be a protective factor against mortality.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
812-822Informations de copyright
© 2020 Blackwell Verlag GmbH.
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