TY  - JOUR
A1  - Warris, Adilia
A1  - Pana, Zoi-Dorothea
A1  - Oletto, Andrea
A1  - Lundin, Rebecca
A1  - Castagnola, Elio
A1  - Lehrnbecher, Thomas
A1  - Groll, Andreas Hermann
A1  - Roilides, Emmanuel
T1  - Etiology and outcome of candidemia in neonates and children in Europe
T2  - The pediatric infectious disease journal
N2  - Background: Data on Candida bloodstream infections in pediatric patients in Europe are limited. We performed a retrospective multicenter European study of the epidemiology and outcome of neonatal and pediatric candidemia.
Material and Methods: All first positive blood cultures from patients ≤ 18 years of age with candidemia were registered. Patients’ demographic and clinical characteristics and causative Candida species were collected and analyzed. Regression analysis was used to identify factors independently associated with mortality.
Results: One thousand three hundred ninety-five episodes of candidemia (57.8% male) were reported from 23 hospitals in 10 European countries. Of the 1395 episodes, 36.4% occurred in neonates (≤ 44 weeks postmenstrual age), 13.8% in infants (> 44 weeks postmenstrual age to 1 year) and 49.8% in children and adolescents. Candida albicans (52.5%) and Candida parapsilosis (28%) were the predominant species. A higher proportion of candidemia caused by C. albicans was observed among neonatal patients (60.2%) with highest rates of C. parapsilosis seen among infants (42%). Children admitted to hematology-oncology wards presented the highest rates of non-albicans Candida species. Candidemia because of C. albicans was more frequent than non-albicans Candida in Northern versus Southern Europe (odds ratio, 2.3; 95% confidence interval, 1.8–2.9; P < 0.001). The all-cause mortality at 30 days was 14.4%. All-cause mortality was higher among patients admitted to the neonatal or pediatric intensive care units than other wards. Over time, no significant changes in species distribution were observed.
Conclusions: This first multicenter European study shows unique characteristics of the epidemiology of pediatric candidemia. The insights obtained from this study will be useful to guide clinical management and antifungal stewardship.
KW  - candidemia
KW  - Candida spp
KW  - neonates
KW  - infants
KW  - children
Y1  - 2020
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/53575
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-535755
SN  - 1532-0987
SN  - 0891-3668
N1  - This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
VL  - 39
IS  - 2
SP  - 114
EP  - 120
PB  - Lippincott Williams & Wilkins ; Ovid
CY  - Hagerstown, Md. ; [s. l.]
ER  -