ABSTRACT 634

Abstract

Background and aims: The fungal infections remain still a great problem in PICU, particularly for what concern the risk factors associated to the little patients. Recently the emergence of non-albicans candida species have been observed. Aims: The aim of our study is to evaluate the incidence of candida albicans and non-albicans species in pediatric patients in which risk factors were observed. Methods: The study was conducted in our institutions, after IRB approval, during the period of 2011–2012. Eight risk factors were considered (prolonged antibiotic use, IV central cannulation, administration of steroid, combination of two or more antibiotics, prolonged mechanical ventilation, surgical procedures, neutropenic patients, total parenteral nutrition). A Candida Score (CS) > 2 was applied togeather with a PICU stay > 6 days. All patients with CS >3 were treated with fluconazole. All hemodynamic and respiratory parameters were recorded and patients followed till discharge from the PICU or death. Results: Candida was found in 31/126 pediatric patients. The P-value was significant (P<0.05) in patients with prolonged mechanical ventilation, total parenteral nutrition, combination of two or more antibiotics. In all other risk factors P-value was >0.05. 65% of the Candida isalated were non-albicans species. Mortality in patients affected from candidaemia was 51.78%. Conclusions: In our study we observed that a high Candida Score associated to the above risk factors have a role on predicting mortality in PICU, particularly in pediatric patients affected from non albicans species.