Candidemia due to uncommon Candida species in children: new threat and impacts on outcomes

Abstract Many uncommon Candida spp. (species other than C. albicans, C. parapsilosis, C. glabrata, C. tropicalis, and C. krusei) have been shown to emerge in tertiary care facilities. We aimed to investigate these uncommon candidemia in children. Forty-six cases of candidemia caused by uncommon Cand...

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Autores principales:	Ming-Horng Tsai, Jen-Fu Hsu, Lan-Yan Yang, Yu-Bin Pan, Mei-Yin Lai, Shih-Ming Chu, Hsuan-Rong Huang, Ming-Chou Chiang, Ren-Huei Fu, Jang-Jih Lu
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2018
Materias:	Albicans Candidemia Guilliermondii Incidence Density Metapsilosis Breakthrough Candidemia Medicine R Science Q
Acceso en línea:	https://doaj.org/article/92004887689b4cf9aa6b9b8284f52bac
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spelling	oai:doaj.org-article:92004887689b4cf9aa6b9b8284f52bac2021-12-02T15:08:07ZCandidemia due to uncommon Candida species in children: new threat and impacts on outcomes10.1038/s41598-018-33662-x2045-2322https://doaj.org/article/92004887689b4cf9aa6b9b8284f52bac2018-10-01T00:00:00Zhttps://doi.org/10.1038/s41598-018-33662-xhttps://doaj.org/toc/2045-2322Abstract Many uncommon Candida spp. (species other than C. albicans, C. parapsilosis, C. glabrata, C. tropicalis, and C. krusei) have been shown to emerge in tertiary care facilities. We aimed to investigate these uncommon candidemia in children. Forty-six cases of candidemia caused by uncommon Candida spp. were identified during 2003–2015 from a medical center in Taiwan. The most common specie was C. guilliermondii (31.2%), followed by C. lusitaniae (18.8%) and C. metapsilosis (18.8%). These cases were analyzed and compared with 148 episodes of C. albicans candidemia. The incidence density of uncommon Candida spp. candidemia and the proportion to all candidemia episodes increased substantively during the study period. Prior exposure to azoles was uncommon in the 30 days prior to infection, but fluconazole resistant strains were significantly more common (n = 19, 41.3%). The increased incidence density of uncommon Candida spp. candidemia was associated with increasing use of antifungal agents. No differences in demographics, underlying comorbidities, risk factors, clinical features, dissemination, and 30-day mortality were found between uncommon Candida spp. and C. albicans candidemia. Patients with uncommon Candida spp. candidemia were more likely to require modifications in antifungal treatment and receive echinocandin drugs (43.5% vs 21.6%, p = 0.007). Candidemia caused by uncommon Candida spp. had poorer response to antifungal treatment, led to longer duration of candidemia (median 4.0 versus 2.5 days, p = 0.008), and had a higher treatment failure rate (56.5% vs 38.5%, p = 0.040).Ming-Horng TsaiJen-Fu HsuLan-Yan YangYu-Bin PanMei-Yin LaiShih-Ming ChuHsuan-Rong HuangMing-Chou ChiangRen-Huei FuJang-Jih LuNature PortfolioarticleAlbicans CandidemiaGuilliermondiiIncidence DensityMetapsilosisBreakthrough CandidemiaMedicineRScienceQENScientific Reports, Vol 8, Iss 1, Pp 1-9 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Albicans Candidemia Guilliermondii Incidence Density Metapsilosis Breakthrough Candidemia Medicine R Science Q
spellingShingle	Albicans Candidemia Guilliermondii Incidence Density Metapsilosis Breakthrough Candidemia Medicine R Science Q Ming-Horng Tsai Jen-Fu Hsu Lan-Yan Yang Yu-Bin Pan Mei-Yin Lai Shih-Ming Chu Hsuan-Rong Huang Ming-Chou Chiang Ren-Huei Fu Jang-Jih Lu Candidemia due to uncommon Candida species in children: new threat and impacts on outcomes
description	Abstract Many uncommon Candida spp. (species other than C. albicans, C. parapsilosis, C. glabrata, C. tropicalis, and C. krusei) have been shown to emerge in tertiary care facilities. We aimed to investigate these uncommon candidemia in children. Forty-six cases of candidemia caused by uncommon Candida spp. were identified during 2003–2015 from a medical center in Taiwan. The most common specie was C. guilliermondii (31.2%), followed by C. lusitaniae (18.8%) and C. metapsilosis (18.8%). These cases were analyzed and compared with 148 episodes of C. albicans candidemia. The incidence density of uncommon Candida spp. candidemia and the proportion to all candidemia episodes increased substantively during the study period. Prior exposure to azoles was uncommon in the 30 days prior to infection, but fluconazole resistant strains were significantly more common (n = 19, 41.3%). The increased incidence density of uncommon Candida spp. candidemia was associated with increasing use of antifungal agents. No differences in demographics, underlying comorbidities, risk factors, clinical features, dissemination, and 30-day mortality were found between uncommon Candida spp. and C. albicans candidemia. Patients with uncommon Candida spp. candidemia were more likely to require modifications in antifungal treatment and receive echinocandin drugs (43.5% vs 21.6%, p = 0.007). Candidemia caused by uncommon Candida spp. had poorer response to antifungal treatment, led to longer duration of candidemia (median 4.0 versus 2.5 days, p = 0.008), and had a higher treatment failure rate (56.5% vs 38.5%, p = 0.040).
format	article
author	Ming-Horng Tsai Jen-Fu Hsu Lan-Yan Yang Yu-Bin Pan Mei-Yin Lai Shih-Ming Chu Hsuan-Rong Huang Ming-Chou Chiang Ren-Huei Fu Jang-Jih Lu
author_facet	Ming-Horng Tsai Jen-Fu Hsu Lan-Yan Yang Yu-Bin Pan Mei-Yin Lai Shih-Ming Chu Hsuan-Rong Huang Ming-Chou Chiang Ren-Huei Fu Jang-Jih Lu
author_sort	Ming-Horng Tsai
title	Candidemia due to uncommon Candida species in children: new threat and impacts on outcomes
title_short	Candidemia due to uncommon Candida species in children: new threat and impacts on outcomes
title_full	Candidemia due to uncommon Candida species in children: new threat and impacts on outcomes
title_fullStr	Candidemia due to uncommon Candida species in children: new threat and impacts on outcomes
title_full_unstemmed	Candidemia due to uncommon Candida species in children: new threat and impacts on outcomes
title_sort	candidemia due to uncommon candida species in children: new threat and impacts on outcomes
publisher	Nature Portfolio
publishDate	2018
url	https://doaj.org/article/92004887689b4cf9aa6b9b8284f52bac
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Candidemia due to uncommon Candida species in children: new threat and impacts on outcomes

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