Department of Pediatric Infectious Diseases, İzmir Katip Celebi University Faculty of Medicine, İzmir, Turkey.
Department of Pediatric Infectious Diseases, Health Sciences University, İzmir Tepecik Training and Research Hospital, İzmir, Turkey.
Microbiol Spectr. 2021 Oct 31;9(2):e0045321. doi: 10.1128/Spectrum.00453-21. Epub 2021 Sep 22.
The aims of the study were to describe species in children with candidemia, to determine the changing epidemiology of candidemia over time in our tertiary care hospital, and to examine the demographic and clinical characteristics of patients with candidemia caused by parapsilosis and nonparapsilosis spp. From 2012 to 2018, we identified a total of 126 cases of candidemia. The most commonly isolated sp. was C. parapsilosis ( = 71, 56.3%), followed by C. albicans ( = 34, 26.9%). A total of 21 candidemia episodes (16.6%) were caused by other species. Patients were divided into two groups (parapsilosis and nonparapsilosis) to identify any potential differences between the groups in terms of risk factors, mortality, and antifungal resistance. The median age of the patients, the median durations of the hospital and pediatric intensive care unit stay, receipt of immunosuppressive therapy within 2 weeks of developing candidemia, the rate of using total parenteral nutrition, need for mechanical ventilation, and receipt of carbapenems were statistically significantly higher in the parapsilosis group than in the nonparapsilosis group ( = 0.020, = 0.001, = 0.011, = 0.036, = 0.002, = 0.038, and = 0.004, respectively). The overall 30-day mortality rates (4.2% versus 3.6%) and resistance to fluconazole (33.8% versus 32.7%) were similar between the groups ( = 0.790 and = 0.860, respectively). The distribution of strains isolated in this study was consistent with the global trend, with C. parapsilosis being the most commonly identified species. Determining local epidemiologic data at regular intervals in candidemia cases is important in terms of determining both the changing epidemiology and empirical antifungal agents. In our study, the changing epidemiology of species in candidemia in children was evaluated. The dominance of Candida parapsilosis species in the changing epidemiology was remarkable. We found that fluconazole resistance was high in both parapsilosis and nonparapsilosis groups. Updating local epidemiologic data at certain intervals in candidemia cases is important in determining both the changing epidemiology and empirical antifungal agents.
本研究的目的是描述儿童念珠菌血症中分离到的菌种,确定我院念珠菌血症的流行病学随时间的变化,并研究近平滑念珠菌和非近平滑念珠菌引起的念珠菌血症患者的人口统计学和临床特征。2012 年至 2018 年,我们共发现 126 例念珠菌血症。最常见的分离菌种为近平滑念珠菌(71 例,占 56.3%),其次为白念珠菌(34 例,占 26.9%)。共有 21 例(16.6%)念珠菌血症由其他菌种引起。为了确定两组之间在危险因素、死亡率和抗真菌药物耐药性方面是否存在任何潜在差异,我们将患者分为两组(近平滑念珠菌组和非近平滑念珠菌组)。两组患者的中位年龄、中位住院时间和儿科重症监护病房住院时间、念珠菌血症发病后 2 周内接受免疫抑制治疗、全胃肠外营养使用率、机械通气需要率和碳青霉烯类药物使用率存在统计学差异(=0.020、=0.001、=0.011、=0.036、=0.002、=0.038 和=0.004)。两组患者的 30 天死亡率(4.2%比 3.6%)和氟康唑耐药率(33.8%比 32.7%)无统计学差异(=0.790 和=0.860)。本研究分离的菌株分布与全球趋势一致,近平滑念珠菌是最常见的鉴定菌种。定期评估念珠菌血症病例中的局部流行病学数据对于确定不断变化的流行病学和经验性抗真菌药物都很重要。在本研究中,我们评估了儿童念珠菌血症中念珠菌属菌种的变化流行病学。念珠菌属菌种变化流行病学中的近平滑念珠菌优势明显。我们发现近平滑念珠菌和非近平滑念珠菌组的氟康唑耐药率都很高。在念珠菌血症病例中定期更新局部流行病学数据对于确定不断变化的流行病学和经验性抗真菌药物都很重要。