Epidemiology, Risk Factors and Outcome of Candida parapsilosis Bloodstream Infection in Children

The Pediatric Infectious Disease Journal, 05/31/2012

Dotis J et al. – C. parapsilosis is the second most frequent cause of candidemia after C. albicans. Although it is more frequent at the age of <2 years and is more likely associated with mechanical ventilation than other Candida spp., mortality does not significantly differ between those with and without C. parapsilosis candidemia.

Methods

  • The authors conducted a retrospective analysis of demographic data, clinical features, therapeutic procedures and outcomes associated with Candida bloodstream infections (BSIs) that occurred at the Children’s Hospital of Philadelphia between 1997 and 2009.

Results

  • Among 406 Candida BSIs, Candida albicans accounted for 198 (49%), C. parapsilosis for 99 (24%) and all other species for 109 (27%) episodes.
  • There was no consistent change in the proportion of C. parapsilosis BSIs during the study. C. parapsilosis BSI was more frequent than non-parapsilosis Candida spp. at age >2 years as compared with older patients.
  • Patients with C. parapsilosis were more likely to be mechanically ventilated within 48 hours of BSI (odds ratio = 1.38, 95% confidence interval: 1.01–1.85, P = 0.047).
  • Presence of a urinary catheter a week before infection was a protective factor for developing candidemia due to C. parapsilosis spp. (P = 0.003).
  • No significant differences were found between the 2 groups in the presence of central intravascular catheters, comorbidities and clinical or surgical procedures, previous administration of immunosuppressive or antifungal agents and mortality.

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