Choi Joon-Sik, Choi Sae Rom, Choi Soo-Han, Ahn Jong Gyun, Kang Ji-Man, Heo Seok-Jae, Yoon Yoonsun, Kim Yun-Kyung, Cho Hye-Kyung, Kim Yae-Jean
Department of Pediatrics, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea.
Wonju Citizen Clinic, Wonju, Korea.
J Korean Med Sci. 2025 Aug 11;40(31):e201. doi: 10.3346/jkms.2025.40.e201.
Invasive candidal infection is a serious health threat to high-risk pediatric populations. Data on pediatric epidemiology of candidemia in Korea are limited.
A retrospective chart review was performed for patients aged 0-18 years who were diagnosed with candidemia from 2009 to 2018 in tertiary hospitals. Patients were divided into two groups; a neonatal group of babies with postnatal age 28 days or younger or any patients hospitalized in neonatal intensive care unit and a pediatric group of the rest of patients. Only the first candidemia episode for each patient was included. species, antifungal sensitivity, underlying condition, and outcomes were investigated.
A total of 228 patients with candidemia were identified from five hospitals. Of them, 87 and 141 were assigned into the neonatal group and the pediatric group, respectively. The most common underlying condition was prematurity (88.5%) in the neonatal group and hematology-oncology diseases (49.6%) in the pediatric group. Non- spp. (65.4%) was more common than . was the most commonly identified species (35.1%), followed by (34.6%), (9.6%), (9.6%), and (2.2%) in all patients. was the most common pathogen in the neonatal group, while was the most common pathogen in the pediatric group. Results of antifungal sensitivity to fluconazole were available for 160 patients. About 11.2% of isolates were either intermediate or resistant to fluconazole (10.0% for non-, 1.2% for ) ( = 0.036). Overall mortality within 30 days after candidemia was 25.4%.
Candidemia caused by non- was more common in pediatric patients during the study period. Resistance to antifungal agents was noted. Monitoring for epidemiologic change is warranted.
侵袭性念珠菌感染对高危儿科人群构成严重的健康威胁。韩国关于念珠菌血症儿科流行病学的数据有限。
对2009年至2018年在三级医院诊断为念珠菌血症的0至18岁患者进行回顾性病历审查。患者分为两组；出生后28天及以下的新生儿组或在新生儿重症监护病房住院的任何患者，以及其余患者组成的儿科组。仅纳入每位患者的首次念珠菌血症发作。调查了菌种、抗真菌敏感性、基础疾病和结局。
从五家医院共识别出228例念珠菌血症患者。其中，分别有87例和141例被归入新生儿组和儿科组。最常见的基础疾病在新生儿组是早产（88.5%），在儿科组是血液肿瘤疾病（49.6%）。非白色念珠菌（65.4%）比白色念珠菌更常见。白色念珠菌是所有患者中最常鉴定出的菌种（35.1%），其次是热带念珠菌（34.6%）、光滑念珠菌（9.6%）、近平滑念珠菌（9.6%）和季也蒙念珠菌（2.2%）。白色念珠菌是新生儿组最常见的病原体，而热带念珠菌是儿科组最常见的病原体。160例患者有氟康唑抗真菌敏感性结果。约11.2%的分离株对氟康唑呈中介或耐药（非白色念珠菌为10.0%，白色念珠菌为1.2%）（P = 0.036）。念珠菌血症后30天内的总体死亡率为25.4%。
研究期间，儿科患者中非白色念珠菌引起的念珠菌血症更为常见。注意到对抗真菌药物的耐药性。有必要监测流行病学变化。
