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Incidence and predictors of invasive candidiasis associated with candidaemia in children
Author(s) -
Festekjian Ara,
Neely Michael
Publication year - 2011
Publication title -
mycoses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.13
H-Index - 69
eISSN - 1439-0507
pISSN - 0933-7407
DOI - 10.1111/j.1439-0507.2009.01785.x
Subject(s) - invasive candidiasis , incidence (geometry) , medicine , echinocandins , pediatrics , intensive care medicine , antifungal , fluconazole , dermatology , caspofungin , physics , optics
Summary Risk factors for invasive candidiasis in children with candidaemia are poorly defined. We performed a retrospective cohort study of all children with candidaemia at our tertiary children’s hospital from 2000 to 2006. Invasive candidiasis was diagnosed by review of the medical record and standardised EORTC/MSG criteria. A variety of risk factors for invasive candidiasis were explored. Of 194 episodes of candidaemia in the microbiology laboratory database, 180 clinical records were available. Evaluation for invasive candidiasis consisted of 174 (97%) echocardiograms, 167 (93%) dilated ophthalmological examinations, 136 (76%) chest CT scans and 108 (60%) abdominal ultrasounds (complete, hepatosplenic or renal). Of the 180 patients, 15 (8%) were identified with invasive candidiasis (4 proven, 1 probable, 10 possible). Prematurity <32 weeks ( P < 0.01), an underlying immunocompromising disorder ( P < 0.01), and ≥2 days of candidaemia ( P = 0.05) were significantly associated with invasive candidiasis. Invasive candidiasis, especially proven or probable, in the setting of candidaemia was not common in our hospital, but premature infants and immunocompromised children were at significantly higher risk. Based on our findings, extensive imaging and examination by an ophthalmologist were particularly low‐yield for invasive candidiasis in immunocompetent children beyond infancy.