Evaluation of Clinical and Epidemiologic Characteristics, Risk Factors and Treatment Regimens of Invasive Candida Infections in Children

Abstract

Invasive candida infections are one of the most common healthcare-associated infections. In this study, we have aimed both to determine the risk factors for invasive fungal infections and to evaluate clinical and epidemiologic characteristics of the cases. Pediatric cases who were followed up due to invasive fungal infection in Eskisehir Osmangazi University Hospital Pediatrics Clinic between January 2015 and March 2023 were included in the study. The study included 41 pediatric cases consisting of 23 (56%) males with an overall average age of 38 months. The most common candida species were Candida albicans (54%), Candida parapsilosis (27%), and Candida glabrata. The most common risk factors were prior antibiotherapy (100%), hospitalization (100%), intensive care unit stay (88%), central catheterization (88%), and total parenteral nutrition (TPN). C.albicans strains were resistant to fluconazole in 5%, caspofungin, and micafungin in 10% of the cases. C. parapicillosis strains were resistant to fluconazole in 37%, caspofungin in 45% micafungin in 55%, and amphotericin-B in only 9% of the cases. TPN use and mortality rates were higher in the C. albicans-infected group, negative blood culture persisted for a longer period in the non-albicans candida group.Invasive fungal infections are among the most important healthcare-associated infectious agents and the most important risk factors include the use of broad-spectrum antibiotics, prolonged hospital and intensive care unit stays, central catheterization, mechanical ventilation, TPN use, increased prophylactic antifungal and steroid use. Although C. albicans is still the most common candida species, C parapsilosis is being identified at an increasing rate.