Non-albicans Candida most responsible for hospital-acquired candidemia

More than half of Candida infections at a single institution were the result of non-albicans species, according to study results.

Researchers from Texas Children’s Hospital aimed to investigate the increasing incidence of non-albicans Candida species as infecting pathogens in pediatric patients with hospital-acquired candidemia.

Eligible participants were aged 6 months to 18 years and had a candidemia blood culture between 2000 and 2009.

There were 276 episodes of candidemia among 226 patients. The median patient age was 50 months (range, 6 months to ≤18 years).

The most frequently observed species was Candida albicans, at 44.2%. However, non-albicans Candida was isolated more frequently, accounting for 55.8% of infections.

C. parapsilosis was the most common non-albicans Candida, at 23.9%; others included C. glabrata (6.5%) and C. lusitaniae (5.4%).

Rates of C. albicans and non-albicans Candida were consistent with regard to demographics, underlying diagnosis, risk factors, clinical features, dissemination and 30-day mortality.

An independent link was observed between disseminated candidiasis and the use of vasopressors (adjusted OR=4.58; 95% CI, 1.03-20.5). Disseminated candidiasis was also independently associated with prolonged fungemia — defined as at least 3 days of persistently positive cultures after catheter removal — (OR=3.2; 95% CI, 1.08-9.3) and with neutropenia (OR=4.06; 95% CI, 1.2–13.2). No association was observed between disseminated candidiasis and non-albicans fungemia.

“Though [C. albicans] was the single most common species, [non-albicans] species collectively have emerged as the predominant pathogens responsible for candidemia in non-neonatal patients at our institution,” the researchers wrote.

Disclosures: There were no financial disclosures reported in this study.

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