Emerging trends in pediatric candidemia: mapping the rise in Candida parapsilosis incidence and antifungal resistance in Turkey.

Autor:	Önal P; Department of Pediatric Infectious Diseases, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, İstanbul 34098, Turkey., Aygün FD; Department of Pediatric Infectious Diseases, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, İstanbul 34098, Turkey., Sever GA; Department of Pediatric Infectious Diseases, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, İstanbul 34098, Turkey., Eren BA; Department of Pediatric Infectious Diseases, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, İstanbul 34098, Turkey., Kes G; Department of Pediatric Infectious Diseases, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, İstanbul 34098, Turkey., Aygün F; Department of Pediatric Intensive Care, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, İstanbul 34098, Turkey., Zübarioğlu T; Department of Pediatric Metabolic Diseases, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, İstanbul 34098, Turkey., Beşer ÖF; Department of Pediatric Gastroenterology, Hepatology and Nutrition, Istanbul University-Cerrahpasa, İstanbul 34098, Turkey., Ocak S; Department of Pediatric Hematology-Oncology, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, İstanbul 34098, Turkey., Yazgan Z; Department of Medical Microbiology, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, İstanbul 34098, Turkey., Zeybek ÇA; Department of Pediatric Metabolic Diseases, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, İstanbul 34098, Turkey., Aygün G; Department of Medical Microbiology, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, İstanbul 34098, Turkey., Camcıoğlu Y; Department of Pediatric Infectious Diseases, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, İstanbul 34098, Turkey., Çokuğraş H; Department of Pediatric Infectious Diseases, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, İstanbul 34098, Turkey.
Jazyk:	angličtina
Zdroj:	Journal of tropical pediatrics [J Trop Pediatr] 2024 Aug 10; Vol. 70 (5).
DOI:	10.1093/tropej/fmae015
Abstrakt:	Candidemia is emerging as a significant concern in children, particularly among those with underlying conditions like malignancies or prematurity. The interpretation of epidemiological data on candidemias and their antifungal resistance plays a vital role in aiding diagnosis and guiding clinicians in treatment decisions. From 2014 to 2021, a retrospective analysis was conducted in İstanbul, Turkey; comparing Candida albicans and non-albicans (NAC) spp in both surviving and deceased groups. Furthermore, an examination of Candida parapsilosis and other species was performed, assessing various clinical and laboratory parameters. Among 93 patients, with a median age of 17 months, C. parapsilosis emerged as the predominant isolated species (44%), followed by C. albicans (34.4%). Resistance to fluconazole, voricanozole, and echinocandins, along with a history of broad-spectrum antibiotic use were found to be significantly higher in the non-albicans Candida group compared to C. albicans group. In the C. parapsilosis group, statistically lower age was identified in comparison to the other groups (P = .018). In addition, high fluconazole and voriconazole resistance was detected in Candida parapsilosis spp. Our study highlights a notable prevalence of C. parapsilosis, particularly in younger children, which is different from similar studies in childhood. This trend may be attributed to the common use of total parenteral nutrition and central venous catheter in gastrointestinal disorders and metabolic diseases. Furthermore, as anticipated, high azole resistance is noted in C. parapsilosis and other non-albicans Candida species. Interestingly, resistance to both amphotericin B and echinocandins within this group has been notably high. It is crucial to emphasize the considerable antifungal resistance seen in C. parapsilosis isolates. (© The Author(s) [2024]. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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