Risk factors and mortality of candidemia in a children's public hospital in Sao Paulo, Brazil

• Published in: Revista argentina de microbiología 2024-07, Vol.56 (3), p.281-286
• Main Authors: Groisman Sieben, Rodrigo, Paternina-de la Ossa, Rolando, Waack, Amaury, Casale Aragon, Davi, Bellissimo-Rodrigues, Fernando, Israel do Prado, Seila, Celia Cervi, Maria
• Format: Article
• Language: English
• Subjects: Candida; Candidemia; Children's infections; Factor de riesgo de mortalidad; Infecciones en niños; Mortality risk factor
• ISSN: 0325-7541
• DOI: 10.1016/j.ram.2023.09.002

•Candida can colonize and invade human surfaces, causing severe infections.•Incidence of candidemia in our study was higher than Latin American.•Non-albicans Candida species were the most frequent, including C. parapsilosis.•Septic shock was the only one with a risk factor for mortality.•Implementing infection control strategies to prevent candidemia and adverse outcomes. Candida bloodstream infections in children are of special concern in neonatal and pediatric intensive care and patients with comorbidities. This study aimed to estimate the incidence and risk factors associated with mortality in candidemia cases occurring in a public children's hospital in Ribeirao Preto, Brazil. It is a retrospective transversal study. Every patient under the age of 18 admitted to the study facility from January 1, 2013, to December 31, 2019, was considered potentially eligible to be included if they had candidemia. We collected clinical data from medical records. We included 113 blood cultures yielding positive results for Candida. The incidence rate was 2.12 per 1000 admissions. The most common Candida species was Candida parapsilosis. Septic shock during the candidemia episode was the only clinical outcome associated with a relative risk-adjusted (RRa) of 2.77 with an interval >1 (1.12–6.85). Our findings show that the incidence rate and mortality rates of candidemia are in line with those in other children's services in Brazil. We found a global mortality rate of 28.31% (32/113) from candidemia episodes. We highlight the predominance of non-albicans Candida species including C. parapsilosis. Septic shock was the most important factor showing a significant risk of mortality. La infección del torrente sanguíneo por Candida es un tema importante en las unidades de cuidados intensivos neonatales y pediátricas, y en niños con comorbilidades. El objetivo de este estudio fue estimar la incidencia de candidemia en un hospital público infantil de Ribeirão Preto, Brasil, e identificar los factores de riesgo de mortalidad por dicha afección. Se hizo un estudio retrospectivo y transversal en el que se incluyeron todos los pacientes menores de 18 años con candidemia admitidos en el hospital desde el 1 de enero de 2013 hasta el 31 de diciembre de 2019. Los datos se obtuvieron de las historias clínicas. Hubo 113 hemocultivos positivos para Candida. La tasa de densidad de incidencia global fue de 2,12 por 1.000 admisiones. La especie de Candida más común fue Candida parapsilosis. El