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Candida spp bloodstream infections in a Latin American Pediatric Oncology Reference Center: Epidemiology and associated factors
Author(s) -
Paixao de Sousa da Silva Adriana Maria,
MoraesPinto Maria Isabel,
Teofilo Pignati Luara,
Barbosa Teixeira Bruno,
Cordeiro Lima Ana Paula,
Costa Pimentel Germano Priscila,
Petrilli Antonio Sergio,
Marques Leticia Maria Acioli,
Carlesse Fabianne
Publication year - 2020
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.13106
Subject(s) - neutropenia , medicine , candida tropicalis , candida parapsilosis , epidemiology , corpus albicans , candida albicans , retrospective cohort study , pediatrics , dermatology , antifungal , chemotherapy , biology , microbiology and biotechnology
Summary 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 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 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 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 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.