Invasive Candidiasis in Infants and Children: Recent Advances in Epidemiology, Diagnosis, and Treatment

Walsh, Thomas J.; Katragkou, Aspasia; Chen, Tempe; Salvatore, Christine M.; Roilides, Emmanuel

doi:10.3390/jof5010011

Cited by 41 publications

(41 citation statements)

References 43 publications

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“…The underlying diseases and risk factors for candidaemia in the various age groups of paediatric patients are different . For instance, as shown in the current study, prematurity, CVC use, mechanical ventilation, broad‐spectrum antibiotic therapy or prophylaxis, receipt of TPN, and long stay at the ICU were the major predisposing factors for neonatal candidaemia, whereas cancer, CVC use, chemotherapy, corticosteroid therapy and antifungal and antibiotic therapy or prophylaxis accounted for most of the candidaemia among infants and children.…”

Section: Discussionsupporting

confidence: 84%

“…This indicates that healthcare-associated risk factors are a good predictor of positive blood culture. 6,14,[19][20][21][22][23][24][25] Strikingly, invasive candidiasis caused by non-albicans Candida species has only been reported in the past two decades. 22 Nonalbicans Candida species have emerged as agents of candidaemia, with an overall decreased incidence rate of C. albicans from 70% to 50% in developed countries.…”

Section: Discussionmentioning

confidence: 99%

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Epidemiological features of nosocomial candidaemia in neonates, infants and children: A multicentre study in Iran

Ahangarkani

Shokohi

Rezai

et al. 2020

Mycoses

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Summary Nosocomial bloodstream candidaemia is a life‐threatening fungal infection with high morbidity and mortality, especially among paediatric patients undergoing intensive immunosuppressive therapy. Limited data on the epidemiology of candidaemia and susceptibility profiles are available for Iran. To characterise candidaemia epidemiology, comorbidity risk factors, species distribution, and antifungal susceptibility profiles among paediatric patients in Iran. This observational cross‐sectional study enrolled 26 189 patients <18 years old at three reference paediatric hospitals in Mazandaran and Tehran over 2 years. Blood samples from patients with suspected fungal bloodstream infection were analysed using the BACTEC culture system. Fungal isolates were identified using matrix‐assisted laser desorption ionisation time‐of‐flight mass spectrometry (MALDI‐TOF) and DNA sequencing. Antifungal susceptibility testing was performed using the Clinical and Laboratory Standards Institute broth microdilution guideline. We observed 109 episodes of nosocomial candidaemia in paediatric patients with or without immunosuppressive therapy. The most common healthcare‐associated factor was central vascular catheter use (97%). The all‐cause mortality rate was 40%, of which 48% was attributable to candidaemia. While Candida albicans was the most frequent causative agent (49%), emerging and uncommon Candida species were also isolated. Candidaemia mortality by non‐albicans Candida species was significantly higher than that by C. albicans (P < .05). All fluconazole‐resistant species were non‐albicans Candida species. Uncommon Candida species with reduced susceptibility to antifungals are emerging as major agents of nosocomial candidaemia in high‐risk paediatric patients in Iran. Appropriate source control, antifungal regimens and improved antifungal stewardship are warranted for managing and decreasing the burden of nosocomial candidaemia.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Epidemiological features of nosocomial candidaemia in neonates, infants and children: A multicentre study in Iran

Ahangarkani

Shokohi

Rezai

et al. 2020

Mycoses

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“…1 Data have additionally shown that the epidemiology of candidemia differs significantly among pediatric and adult populations, especially in terms of Candida species distribution, underlying conditions, risk factors and outcomes. [5][6][7][8][9][10][11][12] Most large prospectively designed epidemiology studies have excluded pediatric patients. Therefore, detailed knowledge of the epidemiology of Candida species among pediatric groups is limited.…”

mentioning

confidence: 99%

Etiology and Outcome of Candidemia in Neonates and Children in Europe

Warris

Pana

Oletto

et al. 2020

Pediatric Infectious Disease Journal

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Background: Data on Candida bloodstream infections in pediatric patients in Europe are limited. We performed a retrospective multicenter European study of the epidemiology and outcome of neonatal and pediatric candidemia. Material and Methods: All first positive blood cultures from patients ≤ 18 years of age with candidemia were registered. Patients' demographic and clinical characteristics and causative Candida species were collected and analyzed. Regression analysis was used to identify factors independently associated with mortality. Results: One thousand three hundred ninety-five episodes of candidemia (57.8% male) were reported from 23 hospitals in 10 European countries. Of the 1395 episodes, 36.4% occurred in neonates (≤ 44 weeks postmenstrual age), 13.8% in infants (> 44 weeks postmenstrual age to 1 year) and 49.8% in children and adolescents. Candida albicans (52.5%) and Candida parapsilosis (28%) were the predominant species. A higher proportion of candidemia caused by C. albicans was observed among neonatal patients (60.2%) with highest rates of C. parapsilosis seen among infants (42%). Children admitted to hematology-oncology wards presented the highest rates of non-albicans Candida species. Candidemia because of C. albicans was more frequent than non-albicans Candida in Northern versus Southern Europe (odds ratio, 2.3; 95% confidence interval, 1.8-2.9; P < 0.001). The all-cause mortality at 30 days was 14.4%. All-cause mortality was higher among patients admitted to the neonatal or pediatric intensive care units than other wards. Over time, no significant changes in species distribution were observed. Conclusions: This first multicenter European study shows unique characteristics of the epidemiology of pediatric candidemia. The insights obtained from this study will be useful to guide clinical management and antifungal stewardship.

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“…Infections by pathogenic fungi are increasingly recognized as an emerging threat to public health (Wu, 1994; Walsh et al, 1996). These problems are associated with resistance to antibiotics and toxicity during prolonged treatment with several antifungal drugs (Giordani et al, 2001).…”

Section: Discussionmentioning

confidence: 99%

Antifungal Activity of M. pudica L. Against Selected Human Pathogens

Vijayalakshmi¹,

Udayakumar²

2018

International Journal of Advanced Scientific Research and Management

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The aim of this study is to determine the antifungal activity of leaf and root extracts of Mimosa pudica against selected fungal pathogens Aspergillus terreus, Aspergillus flavus, Aspergillus niger and Fusarium solani by disc diffusion method. The solvents acetone, aqueous, benzene, diethyl ether and ethanol were used for the preparation of extracts from leaf and root of M. pudica. In this study, various concentrations of extracts 2.5 mg/50 μl, 3.75 mg/75 μl and 5 mg/100 μl were used and prepared discs individually for the determination of antifungal activity against selected fungal pathogens. The prepared discs were placed on each petriplate with respective fungal species along with control dimethyl sulfoxide (DMSO) and standard Iitraconazole (30µg) discs and then the plates were incubated at 27 ºC for 72 hrs. After incubation period, the diameter of zones formed around the discs was measured. The maximum levels of zone of inhibition were observed in ethanol root extract against Aspergillus flavus 20±0.8 mm, Aspergillus terreus 20±0.7 mm and acetone root extract against Aspergillus terreus 18±0.8 mm. The minimum level of zone of inhibition was observed in aqueous leaf extract against Aspergillus terreus 07±0.4 mm and acetone leaf extract against Aspergillus niger 07±0.8 mm. Minimum inhibitory concentration (MIC) of extracts of leaf and root of M. pudica against selected fungal species were also determined. In conclusion, there is in need of study to isolate and purify the active phytocompounds from leaf and root of M. pudica, which possess antifungal activity against above mentioned fungal species and it may be useful in the treatment of fungal diseases.

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Invasive Candidiasis in Infants and Children: Recent Advances in Epidemiology, Diagnosis, and Treatment

Cited by 41 publications

References 43 publications

Epidemiological features of nosocomial candidaemia in neonates, infants and children: A multicentre study in Iran

Epidemiological features of nosocomial candidaemia in neonates, infants and children: A multicentre study in Iran

Etiology and Outcome of Candidemia in Neonates and Children in Europe

Antifungal Activity of M. pudica L. Against Selected Human Pathogens

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