Neonatal and Pediatric Candidemia: Results From Population-Based Active Laboratory Surveillance in Four US Locations, 2009–2015

Benedict, Kaitlin; Roy, Monika; Kabbani, Sarah; Anderson, Evan J.; Farley, Monica M.; Harb, Sasha; Harrison, Lee H.; Bonner, Lindsay; Wadu, Vijitha Lahanda; Marceaux, Kaytlyn; Hollick, Rosemary; Beldavs, Zintar G; Zhang, Alexia Y.; Schaffner, William; Graber, Caroline R; Derado, Gordana; Chiller, Tom; Lockhart, Shawn R.; Vallabhaneni, Snigdha

doi:10.1093/jpids/piy009

Cited by 60 publications

(71 citation statements)

References 46 publications

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“…In line with our findings, a recent US study also showed a decline in C. albicans with increasing age (11). The proportion of C. parapsilosis varies by setting and age, and was low in our setting Our finding that neonatal patients were acutely ill with a high proportion of ICU admission, mechanical ventilation, sepsis and TPN while older children most frequently had hematological diseases and solid cancers is in concordance with previous studies (4,11,19). The high burden of multi-morbidity have not previously been recognized and illustrates the heterogeneity of the pediatric candidemia population, and furthermore identify the underlying diseases for each age group.…”

Section: A C C E P T E Dsupporting

confidence: 93%

“…Conversely, the incidence of 10.2/100.000 population for infants <1 year was higher than reported in our neighboring countries Finland and Norway (6.9 and 7.5/100.000 population) (5,7), but markedly lower than in other population-based studies (15.7-96.4/100.000 population) (6,8,10,11,18). A considerable decline in incidence rates from 52.1/100,000 population in 2009 to 15.7/100.000 in 2015 was observed in a study from the US (11). An improvement in infection control precautions…”

Section: Discussionmentioning

confidence: 99%

“…Incidence rates from population-based studies also vary extensively, but are consistently higher for infants (<1 year) than non-infants with rates in infants ranging from 6.9 to 96.4/100.000 live births (5)(6)(7)(8)(9)(10)(11). The diverging incidence rates call for further insights into clinical characteristics of pediatric candidemia.…”

Section: Introductionmentioning

confidence: 99%

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Pediatric Candidemia Epidemiology and Morbidities

Lausch

Dungu

Callesen

et al. 2019

Pediatric Infectious Disease Journal

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Introduction Candidemia is the most frequent pediatric fungal infection, but incompletely elucidated in population-based settings. We performed a nationwide cohort study including all pediatric patients with candidemia in Denmark from 2004-2014 to determine age, incidence, species distribution, underlying diseases, patient management and outcomes. Methods All candidemia episodes were identified through the active nationwide fungemia surveillance program. Susceptibility testing followed the EUCAST E.Def 7 reference method. Chi-squared test, Fisher's exact test and Venn diagrams were used for statistical analyses. Results 153 pediatric patients (≤15 years) with 158 candidemia episodes were identified. The overall annual incidence rate was 1.3/100,000 population, higher for neonates (5.7/100,000 live births) and low birth weight (LBW) neonates (103.8/100.000 live births). From 2004-9 to 2010-2014, the proportion of C. albicans decreased from 74.4% to 64.7%, whereas fluconazole resistance increased from 7.8% to 17.7%. Virtually all patients had at least one underlying disease (98.6%) and multimorbidity was common (43.5%, ≥2 underlying diseases). Underlying diseases differed by age with heart malformations and gastrointestinal disease prevalent in children younger than 3 years. The overall 30-days mortality was 10.2% and highest for neonates (17.1%). Mortality increased from 2004-to 2010-14, driven by an increase among older children. Discussion This first nationwide epidemiologic study of pediatric candidemia confirmed a high incidence among neonates and a substantial burden of comorbidities. Moreover, an increasing proportion of

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Section: A C C E P T E Dsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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Pediatric Candidemia Epidemiology and Morbidities

Lausch

Dungu

Callesen

et al. 2019

Pediatric Infectious Disease Journal

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“…A recent study of neonatal and paediatric candidemia based on active laboratory surveillance in 4 US locations over the period 2009‐2015 showed that the overall incidence of candidemia in neonates decreased from 31.5 cases/100 000 births in 2009 to 10.7‐11.8 cases between 2012 and 2015. In infants, it decreased from 52.1 cases/100 000 in 2009 to 15.7‐17.5 cases between 2012 and 2015, while in older children it decreased steadily from 1.8 cases in 2009 to 0.8 in 2014 …”

Section: Epidemiology Of Paediatric Candidemiamentioning

confidence: 96%

“…In infants, it decreased from 52.1 cases/100 000 in 2009 to 15.7-17.5 cases between 2012 and 2015, while in older children it decreased steadily from 1.8 cases in 2009 to 0.8 in 2014. 21…”

mentioning

confidence: 99%

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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Invasive fungal disease in children with acute myeloid leukaemia: An Australian multicentre 10‐year review

Yeoh

Moore

Kotecha

et al. 2021

Pediatric Blood & Cancer

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Background Invasive fungal disease (IFD) is a common and important complication in children with acute myeloid leukaemia (AML). We describe the epidemiology of IFD in a large multicentre cohort of children with AML. Methods As part of the retrospective multicentre cohort TERIFIC (The Epidemiology and Risk factors for Invasive Fungal Infections in immunocompromised Children) study, proven/probable/possible IFD episodes occurring in children with primary or relapsed/refractory AML from 2003 to 2014 were analysed. Crude IFD prevalence, clinical characteristics, microbiology and treatment were assessed. Kaplan–Meier survival analysis was used to estimate 6‐month survival. Results There were 66 IFD episodes diagnosed in 63 children with AML. The majority (75.8%) of episodes occurred in the context of primary AML therapy. During primary AML therapy, the overall prevalence was 20.7% (95% CI 15.7%–26.5%) for proven/probable/possible IFD and 10.3% (95% CI 6.7%–15.0%) for proven/probable IFD. Of primary AML patients, 8.2% had IFD diagnosed during the first cycle of chemotherapy. Amongst pathogens implicated in proven/probable IFD episodes, 74.4% were moulds, over a third (37.9%) of which were non‐Aspergillus spp. Antifungal prophylaxis preceded 89.4% of IFD episodes, most commonly using fluconazole (50% of IFD episodes). All‐cause mortality at 6 months from IFD diagnosis was 16.7% with IFD‐related mortality of 7.6% (all in cases of proven IFD). Conclusions IFD is a common and serious complication during paediatric AML therapy. Mould infections, including non‐Aspergillus spp. predominated in this cohort. A systematic approach to the identification of patients at risk, and a targeted prevention strategy for IFD is needed.

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Neonatal and Pediatric Candidemia: Results From Population-Based Active Laboratory Surveillance in Four US Locations, 2009–2015

Cited by 60 publications

References 46 publications

Pediatric Candidemia Epidemiology and Morbidities

Pediatric Candidemia Epidemiology and Morbidities

Candidemia in children: Epidemiology, prevention and management

Invasive fungal disease in children with acute myeloid leukaemia: An Australian multicentre 10‐year review

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