Pérez-Camacho Paola Marsela, Vargas-Moran Carmen, Torres-Canchala Laura, Ariza-Insignares Camila, Sandoval-Calle Lina M, Gómez-Hernández Inés Elvira, Solís-Núñez Paula, Cedeño-Castaño Juliana V, Aguilar-González Ana M, Patiño-Niño Jaime Alberto
Servicio de Infectología Pediátrica, Fundación Valle del Lili, Cali, Colombia; Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia.
Facultad de Ciencias de la Salud, Universidad Icesi, Cali, Colombia; Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia.
Biomedica. 2025 Mar 28;45(1):151-164. doi: 10.7705/biomedica.7444.
Introduction. Candida species are the main etiological agent of fungal infections in the pediatric population, especially in neonates and in intensive care unit patients. Invasive candidiasis is associated with unfavorable clinical outcomes, such as prolonged hospitalization time, and mortality. Objective. To describe demographic, clinical and microbiological characteristics of pediatric patients (older than one month and younger than 18 years) hospitalized in a pediatric intensive care unit with a diagnosis of invasive candidiasis between 2012 and 2020. Materials and methods. A retrospective, observational, cohort study was conducted at a high-complexity center in southwestern Colombia. Results. We included 100 pediatric patients diagnosed with invasive candidiasis, 51% female with a median age of 6.5 years (IQR = 2-11.5). We obtained 114 isolates of Candida spp. The median hospital stay was 51 days (IQR = 29-77), with a pediatric intensive care unit stay of 27 days (IQR = 16-58). Tachycardia was present in 85% of the patients 24 hours before Candida spp. isolation. Nearly half of the isolates were found in bloodstream samples (49.1%), respiratory samples (21.9%), and peritoneal fluid (20.2%). The most frequently isolated species were C. albicans (36.8%), followed by non-albicans species, such as C. parapsilosis (22.8%), and C. tropicalis (21.1%). The overall mortality rate at discharge was 36%. Conclusions. In pediatric intensive care units, invasive candidiasis is a common condition representing a significant threat due to its high morbidity, prolonged hospital stay, and considerable mortality rate. While C. albicans remains as the predominant species, non-albicans Candida species exhibit a growing trend, posing new diagnostic and therapeutic challenges.
引言。念珠菌属是儿科人群真菌感染的主要病原体，尤其是在新生儿和重症监护病房患者中。侵袭性念珠菌病与不良临床结局相关，如住院时间延长和死亡率增加。目的。描述2012年至2020年间在儿科重症监护病房住院且诊断为侵袭性念珠菌病的儿科患者（年龄大于1个月且小于18岁）的人口统计学、临床和微生物学特征。材料与方法。在哥伦比亚西南部的一个高复杂性中心进行了一项回顾性、观察性队列研究。结果。我们纳入了100例诊断为侵袭性念珠菌病的儿科患者，其中51%为女性，中位年龄为6.5岁（四分位间距 = 2 - 11.5）。我们获得了114株念珠菌属分离株。中位住院时间为51天（四分位间距 = 29 - 77），在儿科重症监护病房的停留时间为27天（四分位间距 = 16 - 58）。在念珠菌属分离前24小时，85%的患者出现心动过速。近一半的分离株存在于血液样本（49.1%）、呼吸道样本（21.9%）和腹腔积液（20.2%）中。最常分离出的菌种是白色念珠菌（36.8%），其次是非白色念珠菌，如近平滑念珠菌（22.8%）和热带念珠菌（21.1%）。出院时的总体死亡率为36%。结论。在儿科重症监护病房，侵袭性念珠菌病是一种常见疾病，因其高发病率、延长的住院时间和相当高的死亡率而构成重大威胁。虽然白色念珠菌仍然是主要菌种，但非白色念珠菌呈现出增长趋势，带来了新的诊断和治疗挑战。
