Invasive Candidiasis in pediatric patients at King Fahad Medical City in Central Saudi Arabia. A 5-year retrospective study

Saudi Med J. 2017 Nov;38(11):1118-1124. doi: 10.15537/smj.2017.11.21116.

Abstract

To identify predisposing factors, species distribution, antifungal susceptibility, and outcome. Methods: This study is a retrospective chart review that was conducted at a children's hospital at King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia. One hundred twenty-nine children with invasive candidiasis who were admitted between January 2010 and January 2015. Results: The statistical analysis results have revealed a group of risk factors; prematurity in 37 (28.7%) of patients, low birth weight in 42 (32.6%), central venous catheter in 59 (45.7%), malignancy in 21 (16.3%), immunotherapy in 20 (15.5%), and ventilator support in 60 (46.5%). More than 2-fold mortality rate in patients who had heart vegetation (odds ratio [OR]: 2.9) and patients who had Candida isolated from their blood were more than twice as likely to die as patients with Candida isolated from other sites (OR: 2.2). A total of 48.3% of patients on ventilator died versus 26.1% who were not on ventilator (p=0.009); and 43.8% of patients in the ICU died versus only 24.5% of patients who were not in the ICU (p=0.03). Candida parapsilosis exhibited the highest mortality rate (56.2%). Conclusion: Candida albicans is the most common isolate among all Candida species. Gender, low birth weight, prolonged ICU stay, presence of vegetation, positive blood culture, and mechanical ventilation as a strong predictive risk factors for death in children with invasive candidiasis, a finding that could be applied as prophylactic indicator in critically ill children especially neonates.

MeSH terms

  • Adolescent
  • Candida / classification
  • Candida / isolation & purification
  • Candidiasis / epidemiology*
  • Candidiasis / microbiology
  • Candidiasis / physiopathology
  • Child
  • Child, Preschool
  • Humans
  • Infant
  • Retrospective Studies
  • Saudi Arabia / epidemiology