Candidemia in pediatric patients with congenital heart disease

Risk factors for healthcare-associated infection in pediatric intensive care units: a systematic review

“…Reasons for exclusion at this stage included studies that simultaneously analyzed children and adults 32 , those with no multivariate analysis or with no presentation of association measures 33,34,35 , those in which the outcome was death due to healthcare-associated infection 36 or that reported healthcare-associated infection in paediatric patients analyzing "stay in the pediatric ICU" was one of the risk factors 37,38 . Thirteen papers were selected after consensus, but two of these studies were subsequently excluded, either because the results of the study had already been published on the same population and assessed the same outcome, differing only in sample size 41 , or because the authors performed a randomization of the cases for a validation study of the risk of healthcare-associated infection based on a previously published article 42 .…”

“…Abstracts for which there was no agreement as to the inclusion were analyzed jointly and the decision was made by consensus. Thus, 84 (80 articles and four theses) were ob-tained for detailed reading by the same two authors independently 27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,…”

Candidemia in children after complex congenital heart defects surgery treated with caspofungin – our own experience and a review of literature

“…They are a significant therapeutic problem, since it has been estimated that the attributable mortality of Candida infections in children is 10–15% [11]. It is also reported that in the subgroup of children with CHD after cardiac surgery, the attributable mortality reaches 39%, and in infants below 6 months of age it may be as high as 83% [1,7]. Non-albicans species tend to be more common world-wide in comparison to Candida albicans , which most probably results from frequent administration of azole antifungals and from a concomitant increase of resistance to administered drugs [10].…”

“…We performed an analysis of risk factors for the studied children in respect to risk factors of candidemia described in the literature, which include neutropenia, receipt of immunosuppressive agents, diabetes mellitus, prematurity, primary and/or secondary immune deficiencies, presence of congenital heart defects, prolonged antibiotic therapy (over 5 days), previous Candida species colonization, receipt of total parenteral nutrition, extracorporeal circulation, presence of intravascular thrombus or implantable prosthetic devices, and receipt of renal replacement therapy [1,3,7–10]. Next, we analyzed the course of treatment of candidemia in the selected children and long-term results of the therapy.…”

“…In recent years, those fungal species have become the fourth most common etiological cause of systemic infections in children. Data from the literature suggest that surgical procedures may constitute a significant risk factor, making the spread of infection easier [1]. Due to diagnostic problems and often extremely rapid clinical course, many invasive fungal infections due to Candida species are diagnosed during post-mortem examinations.…”