Abstract
The epidemiology, clinical profile and outcome of pediatric candidemia varies considerably by age, healthcare settings and prevalent Candida species. Despite these differences, few comprehensive studies are undertaken. This nationwide study addresses this knowledge gap. 487 children who contracted ICU-acquired candidemia at 23 Indian tertiary care centers were assessed for 398 variables spanning demography, clinical characteristics, microbiology, treatment and outcome. Both neonates (5.0 days; range=3.0-9.5) and non-neonatal children (7.0 days; range=3.0-13.0) developed candidemia early after ICU admission. Majority of neonates were premature (63.7%) with low birth weight (57.1%). Perinatal asphyxia (7.3%), pneumonia (8.2%), congenital heart disease (8.4%) and invasive procedures were common comorbidities, and antibiotic use (94.1%) was widespread. C. tropicalis (24.7%) and C. albicans (20.7%) dominated both age-groups. Antifungal treatment (66.5%) and removal of central catheters (44.8%) lagged behind. Overall resistance was low, however, emergence of resistant C. krusei and C. auris needs attention. The 30-day crude mortality was 27.8% (neonates) and 29.4% (non-neonates). Logistic regression identified admission to public sec...Continue Reading
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