Liu Suefay Harumi, Mitchell Hana, Nasser Al-Rawahi Ghada
Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Department of Pediatrics, Division of Infectious Diseases, BC Children's Hospital and BC Women's Hospital & Health Centre, Vancouver, British Columbia, Canada.
J Assoc Med Microbiol Infect Dis Can. 2023 Mar 1;8(1):29-39. doi: 10.3138/jammi-2022-0021. eCollection 2023 Mar.
Candidemia represents a significant cause of morbidity and mortality in children. We examined the epidemiology and associated risk factors of candidemia at a Canadian tertiary care paediatric hospital over an 11-year period.
A retrospective chart review was conducted on children with positive blood culture for species between January 1, 2007 and December 31, 2018. Patient demographics, previously described candidemia risk factors, species, follow-up investigations, interventions, and outcome data were included in the analysis.
Sixty-one candidemia episodes were reported with an overall incidence rate of 5.1 cases per 10,000 patient admissions. Of the 66 species identified, the most common was (53%, 35), followed by (18%, 12), and (8%, 5). Mixed candidemia was noted in 8% (5/61) of episodes. The most common risk factors included presence of central venous catheter (95%, 58/61) and receipt of antibiotics in the last 30 days (92%, 56/61). Majority of patients received abdominal imaging (89%, 54/61), ophthalmology consult (84%, 51/61), and echocardiogram (70%, 43/61), regardless of age. Line removal was performed in 81% (47/58) of cases. Evidence of disseminated fungal disease on abdominal imaging was observed in 11% (6/54) of patients, all in non-neonates but with risk factors including immunosuppression and gastrointestinal abnormalities. The overall 30-day case fatality rate was 8% (5/61).
was the most commonly isolated species. Disseminated candidiasis was demonstrated mainly on abdominal imaging in patients with relevant risk factors, including immunosuppression and gastrointestinal abnormalities.
念珠菌血症是儿童发病和死亡的重要原因。我们在一家加拿大三级护理儿童医院对11年间念珠菌血症的流行病学及相关危险因素进行了研究。
对2007年1月1日至2018年12月31日期间血培养念珠菌属阳性的儿童进行回顾性病历审查。分析内容包括患者人口统计学资料、先前描述的念珠菌血症危险因素、念珠菌属种类、后续检查、干预措施及结局数据。
共报告61例念珠菌血症发作，总发病率为每10000例患者入院5.1例。在鉴定出的66种念珠菌中，最常见的是白色念珠菌（53%，35株），其次是光滑念珠菌（18%，12株）和热带念珠菌（8%，5株）。8%（5/61）的发作病例为混合念珠菌血症。最常见的危险因素包括中心静脉导管的存在（95%，58/61）和过去30天内接受过抗生素治疗（92%，56/61）。大多数患者接受了腹部影像学检查（89%，54/61）、眼科会诊（84%，51/61）和超声心动图检查（70%，43/61），与年龄无关。81%（47/58）的病例进行了导管拔除。11%（6/54）的患者腹部影像学检查有播散性真菌病证据，均为非新生儿，但有免疫抑制和胃肠道异常等危险因素。30天总体病死率为8%（5/61）。
白色念珠菌是最常分离出的菌种。播散性念珠菌病主要在有免疫抑制和胃肠道异常等相关危险因素的患者腹部影像学检查中显示。
