Epidemiology, risk factors and outcome of Candida parapsilosis bloodstream infection in children.
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<p><strong>BACKGROUND: </strong>Candida parapsilosis constitutes a common Candida spp. isolated in children with candidemia. Few data exist on risk factors and outcome of candidemia caused by C. parapsilosis in pediatric patients.</p>
<p><strong>METHODS: </strong>We 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.</p>
<p><strong>RESULTS: </strong>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 (62% versus 50%, odds ratio = 1.24, 95% confidence interval: 1.03-1.51, P = 0.038). 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.</p>
<p><strong>CONCLUSIONS: </strong>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.</p>
Pediatr. Infect. Dis. J.