The Turkish Journal of Pediatrics
2011 , Vol 53 , Num 5
Invasive Candida Infections in Children: The Clinical Characteristics and Species Distribution and Antifungal Susceptibility of Candida spp
1Department of Pediatric Infectious Diseases, Ondokuz Mayıs University Faculty of Medicine, Samsun, and Departments of
2Pediatric Infectious Diseases, 3Pediatrics, 4Pediatric Hematology, 5Pediatric Oncology, 6Neonatology, 7Pediatric Immunology
and Allergy, 8Pediatric Intensive Care Unit, and 9Pediatric Gastroenterology, Ankara University Faculty of Medicine,
Ankara, Turkey
The aims of the study were to examine the distribution of Candida spp.
isolated from sterile body sites, the antifungal susceptibility of the isolates
to amphotericin B, fluconazole, voriconazole, and caspofungin, and factors
affecting mortality with invasive Candida infections in children. Thirty-five
children with invasive candidiasis between January 2004 and January 2008
were evaluated retrospectively. The antifungal susceptibility of isolated Candida
species was studied by Etest. Of the invasive Candida infections, 65.7%
were due to C. albicans. The second most common isolated species was C.
parapsilosis (11.4%). The rates of resistance to fluconazole, amphotericin B
and voriconazole were 8.5%, 2.8% and 5.7%, respectively. Caspofungin was
the most effective antifungal agent. 22.8% of the patients died in the first
30 days. In univariate analyses, increased mortality was associated with stay
in the intensive care unit, the presence of central venous catheter (CVC),
failure to remove CVC, and mechanical ventilation.
Keywords :
invasive candidiasis, children, risk factors, antifungal susceptibility.