Evaluation for Metastatic Candida Focus and Mortality at Candida-associated Catheter-related Bloodstream Infections at the Pediatric Hematology-oncology Patients.

Duzgol M., Boncuoglu E., Kiymet E., Akaslan Kara A., Erdem M., Odaman Al I., ...More

Journal of pediatric hematology/oncology, vol.44, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 44
  • Publication Date: 2022
  • Doi Number: 10.1097/mph.0000000000002197
  • Journal Name: Journal of pediatric hematology/oncology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CAB Abstracts, EMBASE, MEDLINE
  • Keywords: invasive fungal infection, Candida species, infective endocarditis, hepatosplenic candidiasis, INVASIVE FUNGAL-INFECTIONS, DISEASES SOCIETY, ENDOCARDITIS, EPIDEMIOLOGY, CHILDREN, FLUCONAZOLE, MANAGEMENT, THERAPY, GUIDELINE, ETIOLOGY
  • Bursa Uludag University Affiliated: Yes


Background: Candidemia and Candida-associated catheter-related bloodstream infections (CRBSIs) are the significant cause of mortality and morbidity in patients with malignancy. Methods: A retrospective analysis including all pediatric hematologic/oncologic malignancies patients with CRBSIs treated in Dr. Behcet Uz Children Diseases and Surgery Training and Research Hospital between the period of 2009 and 2020. Results: During the study period, 53 children with CRBSIs associated with Candida species were included. The most common malignancy was acute lymphoblastic leukemia (45.3%) and acute myeloid leukemia (15.1%). A total of 56 Candida isolates were present including non-albicans Candida species (80.4%) and Candida albicans (19.6%). The most common isolated Candida species was Candida parapsilosis (42.9%) and followed by C. albicans (19.6%). The ratio of azole prophylaxis was significantly higher in patients with the non-albicans Candida group (P=0.031). Candida-related endocarditis (vegetation) was present in 2 (3.8%) patients, and the overall rate of hepatosplenic candidiasis was 3.8%. Seven days Candida attributable mortality was 7.5% (4 patients) and 30 days Candida attributable mortality was 11.3% (6 patients). The Candida species responsible for the Candida-related deaths were as following: Candida tropicalis (n=3), C. parapsilosis (n=2), and C. lusitanae (n=1). Conclusion: In pediatric cancer patients with Candida-associated CRBSIs, evaluation of the patient for organ involvement including liver and spleen ultrasonography and cardiac involvement with echocardiography are essential regardless of the patients' clinical picture.