Epidemiological Profile Of Candidemia In Pediatric Oncohematological Patients: A Retrospective Study
Lohanna V S Tavares, Aldaíza M Ribeiro, Nerci S C Ciarlini, Renan V F Torres, Virgínia M R Sampaio, Paulo H S Peixoto, Marília A Bomfim, Diane C Oliveira, Verônica F AlvesAbstract
Background
Candidemia is a leading cause of invasive fungal infections in hospitalized children. Clinical manifestations can range from isolated fever to disseminated infection leading to multiple organ failure and it is an important cause of morbidity and mortality, especially in immunocompromised patients. The epidemiology of invasive candidiasis has been changing in recent years, and the most common non-albicans strain is C. parapsilosis. The objective is to analyze the epidemiological profile of candidemia in pediatric oncohematological patients.
Methods
Cross-sectional, retrospective study, carried out using databases from the microbiology system and the Hospital Infection Control Service of the institution regarding bloodstream infections by Candida spp, from January 2023 to December 2024, with evaluation of socioepidemiological, microbiological and clinical aspects, comparing with data present in the literature.
Results
Seventy-three patients with a median age of 6 years participated in the study, 55% (n=40) were male and 45% (n=33) female. Regarding underlying diseases, 51% (n=37) of the patients had leukemia, 14% (n=10) lymphoma, 23% (n=17) solid tumors, 8% (n=6) central nervous system tumors and 4% (n=3) benign hematologic diseases. The species identified were C. parapsilosis in 64% (n=47) of the cases, C. tropicalis in 15% (n=11), C. guilliermondii in 12% (n=9), C. krusei in 4% (n=3) and C. albicans in 4% (n=3). Neutropenia was observed in 73% (n=53) patients and 100% had a central venous catheter. Furthermore, 15% (n=11) had more than one positive blood culture on different days and 18% (n=13) died.
Conclusions
Candidemia remains prevalent, with mortality ranging from 7.7% to 26% and an increase in non-albicans species, as demonstrated in this study. Identifying Candida species is crucial for determining the optimal treatment approach. The data presented show the relevance of candidemia in pediatric oncohematological patients. Despite advances in infection control practices, candidemia remains a significant threat and monitoring, prevention and treatment are essential to reduce incidence and improve clinical outcomes.