Candidemia and invasive candidiasis among hospitalized neonates and pediatric patients

Harrington, Rachel; Kindermann, Sylvia L.; Hou, Qi; Taylor, Robert J.; Azie, Nkechi; Horn, David L.

doi:10.1080/03007995.2017.1354824

Cited by 35 publications

(30 citation statements)

References 16 publications

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“…In 2000, the incidence of candidemia in the US was higher in children than in adults (43 vs 30 per 100 000 children per year) and was associated with a mean 21.1‐day increase in length of hospital stay and a mean increase of $92 266 in total per‐patient hospital charges, figures substantially higher than in hospitalised adults . The association between paediatric candidemia and increased resource utilisation and length of hospital stay has been confirmed in a recent retrospective observational study using the Health Facts Database, a proprietary “real‐world” database built from participating hospitals' comprehensive clinical records, including laboratory tests and microbiology lab information …”

Section: Epidemiology Of Paediatric Candidemiamentioning

confidence: 90%

Candidemia in children: Epidemiology, prevention and management

Mantadakis

Pana

Zaoutis

2018

Mycoses

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Candidemia is the leading cause of invasive fungal infections in hospitalised children. The highest rates of candidemia have been recorded in neonates and infants <1 year of age. Candidemia is more frequent in neonates and young infants than in adults, and is associated with better clinical outcomes, but higher inpatient costs. Over the last 10 years, a declining trend has been noted in the incidence of paediatric candidemia in the US and elsewhere due to the hospital-wide implementation of central-line insertion and maintenance bundles that emphasise full sterile barrier precautions, chlorhexidine skin preparation during line insertion, meticulous site and tubing care, and daily discussion of catheter necessity. Additional interventions aiming at reducing gut-associated candidemia are required in immunocompromised and critically ill children.

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Section: Epidemiology Of Paediatric Candidemiamentioning

confidence: 90%

Candidemia in children: Epidemiology, prevention and management

Mantadakis

Pana

Zaoutis

2018

Mycoses

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“…The occurrence of C. parapsilosis on the skin and nails of healthy individuals, including hospital personnel, and on the surfaces of medical devices, coincides with its strong biofilm‐forming ability. These attributes are responsible for its prevalence as a cause of invasive nosocomial infections, with a mortality rate of ~10%, especially in critically ill neonates and pediatric patients with prolonged hospital stays …”

Section: Candida Yeasts—common Fungal Pathogens In Humansmentioning

confidence: 99%

“…These attributes are responsible for its prevalence as a cause of invasive nosocomial infections, with a mortality rate of ~10%, especially in critically ill neonates and pediatric patients with prolonged hospital stays. 21 In many areas, C. tropicalis is more frequent than other Candida species isolated from patients with bloodstream candidal infections, especially in those who suffer from hematological malignancies. 14,22 Candida tropicalis exhibits a greater ability than C. albicans to spread within humans.…”

Section: Candida Yeasts-common Fungal Pathogens In Humansmentioning

confidence: 99%

Extracellular proteinases of Candida species pathogenic yeasts

Rapała‐Kozik

Bocheńska

Zając

et al. 2018

Molecular Oral Microbiology

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The increased incidence of severe disseminated infections caused by the opportunistic yeast-like fungi Candida spp. highlights the urgent need for research into the major virulence factors of these pathogens-extracellular aspartic proteinases of the candidapepsin and yapsin families. Classically, these enzymes were considered to be generally destructive factors that damage host tissues and provide nutrients for pathogen propagation. However, in recent decades, novel and more specific functions have been suggested for extracellular candidal proteinases. These include contributions to cell wall maintenance and remodeling, the formation of polymicrobial biofilms, adhesion to external protective barriers of the host, the deregulation of host proteolytic cascades (such as the complement system, blood coagulation and the kallikrein-kinin system), a dysregulated host proteinase-inhibitor balance, the inactivation of host antimicrobial peptides, evasion of immune responses and the induction of inflammatory mediator release from host cells. Only a few of these activities recognized in Candida albicans candidapepsins have been also confirmed in other Candida species, and characterization of Candida glabrata yapsins remains limited.

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“…Of these, Candida parapsilosis is of particular importance, as it is able to form tenacious biofilms on central venous catheters (CVCs) and other medically implanted devices, thus threatening patients who have undergone invasive medical interventions. C. parapsilosis likewise grows rapidly in total parenteral nutrition administered to ICU patients, thereby placing undernourished children and low-birth-weight neonates (5)(6)(7)(8) at increased risk. Although C. parapsilosis infections generally result in lower morbidity and mortality rates than C. albicans infections, several clinical isolates of this species have been reported to be less susceptible to echinocandins, and in some regions, resistance to azole treatment has also been noted, which complicates the choice of empirical antifungal drug therapy (9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

Candida parapsilosis: from Genes to the Bedside

et al. 2019

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SUMMARY Patients with suppressed immunity are at the highest risk for hospital-acquired infections. Among these, invasive candidiasis is the most prevalent systemic fungal nosocomial infection. Over recent decades, the combined prevalence of non-albicans Candida species outranked Candida albicans infections in several geographical regions worldwide, highlighting the need to understand their pathobiology in order to develop effective treatment and to prevent future outbreaks. Candida parapsilosis is the second or third most frequently isolated Candida species from patients. Besides being highly prevalent, its biology differs markedly from that of C. albicans, which may be associated with C. parapsilosis’ increased incidence. Differences in virulence, regulatory and antifungal drug resistance mechanisms, and the patient groups at risk indicate that conclusions drawn from C. albicans pathobiology cannot be simply extrapolated to C. parapsilosis. Such species-specific characteristics may also influence their recognition and elimination by the host and the efficacy of antifungal drugs. Due to the availability of high-throughput, state-of-the-art experimental tools and molecular genetic methods adapted to C. parapsilosis, genome and transcriptome studies are now available that greatly contribute to our understanding of what makes this species a threat. In this review, we summarize 10 years of findings on C. parapsilosis pathogenesis, including the species’ genetic properties, transcriptome studies, host responses, and molecular mechanisms of virulence. Antifungal susceptibility studies and clinician perspectives are discussed. We also present regional incidence reports in order to provide an updated worldwide epidemiology summary.

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Candidemia and invasive candidiasis among hospitalized neonates and pediatric patients

Abstract: This analysis confirms the association between pediatric candidemia and increased resource utilization and LOS. Given high observed rates of potential under-treatment, an opportunity may exist to improve AF therapy in this population.

Cited by 35 publications

References 16 publications

Candidemia in children: Epidemiology, prevention and management

Candidemia in children: Epidemiology, prevention and management

Extracellular proteinases of Candida species pathogenic yeasts

Candida parapsilosis: from Genes to the Bedside

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