Candidemia in the pediatric intensive care unit in Eastern India

Abstract

Background: Nosocomial infection, due to Candida, contracted in the pediatric intensive care unit (PICU), is emerging as a significant healthcare challenge. The incidence of non-albicans Candida as a cause of candidemia is on the rise, unlike in previous decades. Materials and Methods: All the cases of candidemia confirmed by culture, admitted to the PICU during the study period of January 2017 to December 2019, were retrospectively studied. The prevalence, speciation, sensitivity pattern and risk factors of candidemia mortality were recorded and analyzed. Results: There were 1034 admissions to the PICU in the study period, of which 926 blood samples were sent for culture and sensitivity. A total of 31 Candida non-albicans and five Candida albican species were isolated. C. tropicalis was the most common type (44.4%) of Candida species found, followed by C. glabrata (16.7%), C. parapsilosis (16.7%) and C. krusei (5.6%). The sensitivity of all Candida isolates to Amphotericin B, Clotrimazole, Voriconazole, Itraconazole, Ketoconazole, Nystatin, and Fluconazole was 94.4%, 91.7%, 88.9%, 86.1%, 77.8%, 52.8%, and 38.9% respectively. The use of a central venous catheter was a statistically significant contributor to mortality due to candidemia. Conclusion: Non-albican Candida species are the predominant cause of candidemia this study. They are associated with higher fatality rates. Sensitivity of the Candida spp. was more common to Amphotericin-B than azoles.

Keywords

• antifungal susceptibility
• non-albicans candida
• pediatric intensive care