Characteristics, outcome and risk factors for mortality of paediatric patients with icu‐acquired candidemia in india: a multicentre prospective study
Mycoses Sep 26, 2020
Chakrabarti A, Sood P, Rudramurthy SM, et al. - Via this nationwide study, researchers sought to report on the variation observed in the epidemiology, clinical profile and outcome of pediatric candidemia by age, healthcare settings and prevalent Candida species. They assessed 487 children who contracted ICU‐acquired candidemia at 23 Indian tertiary care centers and identified development of candidemia early after ICU admission in both neonates and non‐neonatal children. Neonates, in majority, were premature (63.7%) with low birthweight (57.1%). Common comorbidities were perinatal asphyxia (7.3%), pneumonia (8.2%), congenital heart disease (8.4%) and invasive procedures, and widespread use of antibiotic (94.1%) was noted. Dominance of C tropicalis (24.7%) and C albicans (20.7%) was noted in both age groups. As per logistic regression, following were independent predictors of 30‐day crude mortality in neonates: admission to public sector ICUs, mechanical ventilation, corticosteroid therapy and antifungal therapy. Similarly, following were independent predictors for non‐neonates: admission to public sector ICUs, mechanical ventilation , exposure to carbapenems and azole antifungal therapy. Findings are thus suggestive of a distinct epidemiology, including early infection with a different spectrum of Candida species, which call for relevant intervention strategies to decrease candidemia morbidity and mortality.
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