Epidemiologic and microbiologic evaluation of nosocomial infections associated with Candida spp in children: A multicenter study from Istanbul, Turkey

Am J Infect Control. 2016 Oct 1;44(10):1139-1143. doi: 10.1016/j.ajic.2016.03.056. Epub 2016 Jun 20.

Abstract

Background: The purpose of this study was to establish species distribution of Candida isolates from pediatric patients in Istanbul, Turkey, and to determine risk factors associated with nosocomial Candida infections.

Methods: This study was conducted between June 2013 and June 2014 by participation of 7 medical centers in Istanbul. Candida spp strains isolated from the clinical specimens of pediatric patients were included. Clinical features were recorded on a standardized data collection sheet.

Results: A total of 134 systemic Candida infections were identified in 134 patients. The patients were admitted in pediatric and neonatal intensive care units (41.8% and 9.7%, respectively) and in pediatric wards (48.5%). Candida albicans was the most prevalent species (47%), followed by Candida parapsilosis (13.4%), Candida tropicalis (8.2%), Candida glabrata (4.5%), Candida lusitaniae (3.7%), Candida kefyr (2.2%), Candida guilliermondii (1.5%), Candida dubliniensis (0.7%), and Candida krusei (0.7%). Types of Candida infections were candidemia (50.7%), urinary tract infection (33.6%), surgical site infection (4.5%), central nervous system infection (3.7%), catheter infection (3.7%), and intra-abdominal infection (3.7%). In multivariate analysis, younger age (1-24 months) and detection of non-albicans Candida spp was found to be risk factors associated with candidemia (P = 0.040; odds ratio [OR], 4.1; 95% confidence interval [CI], 1.06-15.86; and P = 0.02; OR, 2.4; 95% CI, 1.10-5.53, respectively).

Conclusions: This study provides an update for the epidemiology of nosocomial Candida infections in Istanbul, which is important for the management of patients and implementation of appropriate infection control measures.

Keywords: Candida albicans; Systemic candidiasis; candidemia; candiduria; children; non-albicans Candida.

Publication types

  • Multicenter Study

MeSH terms

  • Candida / isolation & purification*
  • Candida albicans / isolation & purification
  • Candidemia / epidemiology*
  • Candidemia / microbiology
  • Candidiasis / epidemiology*
  • Candidiasis / microbiology
  • Child, Preschool
  • Cross Infection*
  • Female
  • Hospitals
  • Humans
  • Infant
  • Infant, Newborn
  • Intensive Care, Neonatal
  • Male
  • Risk Factors
  • Turkey / epidemiology
  • Urinary Tract Infections / drug therapy
  • Urinary Tract Infections / epidemiology*
  • Urinary Tract Infections / microbiology

Supplementary concepts

  • Systemic candidiasis