More than half of Candida infections at a single
institution were the result of non-albicans species, according to study
Researchers from Texas Childrens 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
The most frequently observed species was Candida albicans, at 44.2%. However,
non-albicans Candida was isolated more frequently, accounting for 55.8%
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, 1.213.2). 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.