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Candidemia due to uncommon Candida species in children: new threat and impacts on outcomes.
- Source :
-
Scientific reports [Sci Rep] 2018 Oct 15; Vol. 8 (1), pp. 15239. Date of Electronic Publication: 2018 Oct 15. - Publication Year :
- 2018
-
Abstract
- Many uncommon Candida spp. (species other than C. albicans, C. parapsilosis, C. glabrata, C. tropicalis, and C. krusei) have been shown to emerge in tertiary care facilities. We aimed to investigate these uncommon candidemia in children. Forty-six cases of candidemia caused by uncommon Candida spp. were identified during 2003-2015 from a medical center in Taiwan. The most common specie was C. guilliermondii (31.2%), followed by C. lusitaniae (18.8%) and C. metapsilosis (18.8%). These cases were analyzed and compared with 148 episodes of C. albicans candidemia. The incidence density of uncommon Candida spp. candidemia and the proportion to all candidemia episodes increased substantively during the study period. Prior exposure to azoles was uncommon in the 30 days prior to infection, but fluconazole resistant strains were significantly more common (n = 19, 41.3%). The increased incidence density of uncommon Candida spp. candidemia was associated with increasing use of antifungal agents. No differences in demographics, underlying comorbidities, risk factors, clinical features, dissemination, and 30-day mortality were found between uncommon Candida spp. and C. albicans candidemia. Patients with uncommon Candida spp. candidemia were more likely to require modifications in antifungal treatment and receive echinocandin drugs (43.5% vs 21.6%, p = 0.007). Candidemia caused by uncommon Candida spp. had poorer response to antifungal treatment, led to longer duration of candidemia (median 4.0 versus 2.5 days, p = 0.008), and had a higher treatment failure rate (56.5% vs 38.5%, p = 0.040).
- Subjects :
- Adolescent
Antifungal Agents classification
Candida isolation & purification
Candidemia diagnosis
Child
Child, Preschool
Communicable Diseases, Emerging diagnosis
Communicable Diseases, Emerging drug therapy
Communicable Diseases, Emerging epidemiology
Communicable Diseases, Emerging microbiology
Female
Humans
Incidence
Infant
Infant, Newborn
Male
Microbial Sensitivity Tests
Mortality
Prognosis
Retrospective Studies
Risk Factors
Taiwan epidemiology
Treatment Outcome
Antifungal Agents therapeutic use
Candida classification
Candidemia drug therapy
Candidemia epidemiology
Candidemia microbiology
Subjects
Details
- Language :
- English
- ISSN :
- 2045-2322
- Volume :
- 8
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Scientific reports
- Publication Type :
- Academic Journal
- Accession number :
- 30323257
- Full Text :
- https://doi.org/10.1038/s41598-018-33662-x