Department of Peadiatrics, University of Health Sciences, Kartal Koşuyolu Research and Training Hospital, Istanbul, Turkey.
Anesthesiology and Reanimation Department, University of Health Sciences, Kartal Koşuyolu Research and Training Hospital, Istanbul, Turkey.
Cardiol Young. 2023 Feb;33(2):301-305. doi: 10.1017/S1047951122000737. Epub 2022 Mar 10.
Candida infections have become one of the most common causes of morbidity and mortality in paediatric ICUs, especially following complex surgeries, all over the world. Therefore, we conducted a 5-year analysis of Candida bloodstream infections in our tertiary paediatric cardiovascular surgery ICU.
One thousand nine hundred and thirty four children, 0-16-year-old, who underwent paediatric cardiovascular surgery between January 2016-June 2021 were enrolled in this retrospective study. Blood cultures obtained from 1056 patients, who needed mechanical ventilation and indwelling devices longer than 5 days and had the signs of infection according to Center for Disease Control criteria, were evaluated. The isolated pathogens were recorded. 137 with Candida bloodstream infections were reanalysed for their age, weight, cardiac pathologies, duration of mechanical ventilation, hospitalisation and antibiotic use.
One hundred and thirty-seven out of one thousand and fifty six patients (12.9%) had Candida growth in their blood cultures. (n: 50, 36.5%), (n: 20, 14.6%), (n: 8, 5.8%), (n: 5, 3.7%), and other non-albicans Candida species (n: 54, 39.4%) were isolated. The patients with Candida bloodstream infections had lower age, longer duration of mechanical ventilation, longer length of hospital stay and antibiotic use (p-values<0.05). They had cardiac pathologies as atrioventricular septal defect (18.9%), transposition of great arteries (17.6%), tetralogy of Fallot (12.4%), transposition of great arteries + double outlet right ventricle, or total anomalous pulmonary venous return + atrioventricular septal defect (37.9%), and others. The Candida bloodstream infections mortality was 11.6% (16/137).
The most common cause of Candida bloodstream infections in the last five years in our paediatric cardiovascular surgery ICU was non-albicans Candida species. Prolonged mechanical ventilation, hospitalisation and antibiotic use, low age, and weight were found as the main risk factors that raise the morbidity and mortality rates of Candida bloodstream infections.
念珠菌感染已成为全球儿科 ICU 发病率和死亡率的最常见原因之一，尤其是在复杂手术后。因此，我们对我院儿科心血管外科 ICU 5 年来的念珠菌血流感染进行了分析。
本回顾性研究纳入了 2016 年 1 月至 2021 年 6 月期间 1934 名 0-16 岁接受儿科心血管手术的患儿。对 1056 名需要机械通气和留置装置超过 5 天且根据疾病控制中心标准有感染迹象的患儿的血培养进行了评估。记录分离出的病原体。对 137 例念珠菌血流感染患儿的年龄、体重、心脏病变、机械通气时间、住院时间和抗生素使用情况进行了重新分析。
1056 例患儿中，137 例（12.9%）血培养中出现念珠菌生长。最常见的病原体为 （n：50，36.5%）、 （n：20，14.6%）、 （n：8，5.8%）、 （n：5，3.7%）和其他非白念珠菌属念珠菌（n：54，39.4%）。念珠菌血流感染患儿的年龄较小，机械通气时间较长，住院时间和抗生素使用时间较长（p 值均<0.05）。心脏病变包括房室隔缺损（18.9%）、大动脉转位（17.6%）、法洛四联症（12.4%）、大动脉转位+右心室双出口或完全性肺静脉异位引流+房室隔缺损（37.9%）和其他病变。念珠菌血流感染患儿的死亡率为 11.6%（16/137）。
过去 5 年，我院儿科心血管外科 ICU 最常见的念珠菌血流感染病原体是非白念珠菌属念珠菌。延长机械通气、住院和使用抗生素、低龄和低体重是导致念珠菌血流感染发病率和死亡率升高的主要危险因素。
