Çocuk Yoğun Bakım Ünitesi'nde Kandida Sepsisi ve Risk Faktörleri

Abstract

In recent years, the incidence of fungal infections has increased. The majority of hospital-acquired fungal infections are caused by Candida species. Recently, with an increase of chronic diseases frequency and invasive procedures, the incidence of candidemia increases as a result of administration of broad-spectrum antibiotic. The most common invasive fungal infections in the pediatric intensive care unit are Candida and Aspergillus species. Invasive fungal infections increase morbidity and mortality. The aim of this study was to evaluate the demographic, laboratory and risk factors of pediatric patients who developed candidemia due to C. albicans and non-albicans Candida species in pediatric intensive care unit. In this study, 20 patients aged between 1 months and 18 years old and who developed candidemia in between January 2014 and February 2018 were included. The diagnosis of candidemia was done according to the diagnostic criteria of surveillance which defined by the Center for Disease Control and Prevention. Demographic data, clinica/laboratory findings, and interventions have been recorded. The median age of the patients was 12.5 months and 50% (n=10) were girls and 50% (n=10) were boys. There were 17 patients with catheters (85%), two patients with neutropenia and one patient with intraabdominal surger; none of the patients had history of immunosupression. All patients have invasive mechanical ventilation when they were diagnosed with candidemia. The median duration of mechanical ventilation was 33 days. The most common isolated candida specie was C. albicans (n=9; 45%). Non-albicans Candida species were detected in 11 (55%) patients and most common type was C. parapisilosis (n=8;40%). Despite appropriate treatment, 7 (%35) patients were died. In whole study group, 44% patients with C. albicans and 36.4% of patients with non-albicans Candida was died. No statistically significant difference was found between the mortality rates and the type of isolated candida species (p>0.05). Elimination of risk factors leading to candidemia sepsis, rapid removal of the catheter after candida reproduction may reduce the mortality associated with candidemia.