z-logo
Premium
Candidaemia in a paediatric centre and importance of central venous catheter removal
Author(s) -
KaradagOncel Eda,
Kara Ates,
Ozsurekci Yasemin,
ArikanAkdagli Sevtap,
Cengiz Ali Bulent,
Ceyhan Mehmet,
Gur Deniz,
Celik Melda,
OzkayaParlakay Aslinur
Publication year - 2015
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/myc.12288
Subject(s) - medicine , mechanical ventilation , central venous catheter , candida tropicalis , candida albicans , retrospective cohort study , candida parapsilosis , gastroenterology , catheter , surgery , biology , antifungal , microbiology and biotechnology , dermatology
Summary The aim of this study is to identify differences in distribution of Candida species , resistance to antifungals and clinical outcome, as well as the identification of potential risk factors associated with candidaemia in children. We conducted a retrospective analysis in children ≤18 years with blood culture proven candidaemia identified between 2004 and 2012. Patients were divided into two groups (Group 1, <3 months, n  = 51; Group 2, ≥3 months, n  = 197) to identify any potential difference between the neonatal and early infantile periods in terms of risk factors and distribution of Candida species. A total of 248 distinct episodes of candidaemia were identified over the study period. The most frequently isolated Candida species were C. albicans (53.2%), followed by C. parapsilosis (26.2%), C. tropicalis (8.1%). Of the 248 episodes, 71 episodes (28.6%) resulted in death within 30 days from the onset of candidaemia. In Group 1, failure of central venous catheter ( CVC ) removal was found to be associated with a 20.5‐fold increase in mortality [95% CI (3.9, 106.5); P  < 0.001], compared to a 5.9‐fold increased risk with hypoalbuminaemia [95% CI (1.03, 34.1); P  = 0.046]. For Group 2, the increased risk was 23‐fold for failure of CVC removal [95% CI (7.48, 70.77); P  < 0.001], 7.4‐fold for mechanical ventilation [95% CI (2.64, 21.08); P  < 0.001], 4.4‐fold for hypoalbuminaemia [95% CI (1.56, 12.56); P  = 0.005], 3.1‐fold for neutropaenia [95% CI (1.31, 7.69); P  = 0.010] and 2.2‐fold for male gender [95% CI (1.02, 4.71); P  = 0.043]. Therapeutic choices should be guided by sound knowledge of local epidemiological trends in candidaemia. Removal of CVC significantly reduces mortality and is an essential step in the management of candidaemia.

This content is not available in your region!

Continue researching here.

Having issues? You can contact us here