Distribution of candida species and risk factors for invasive candidiasis

Ali Korulmaz, Mehmet Alakaya, A. Arslankoylu, Sadi Kaya, S. Erdoğan, Didem Ozgur, Z. F. Otağ
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Abstract

Aim: The aim of this study was to investigate the Candida species isolated from the clinical samples of patients in the pediatric intensive care unit and to determine the risk factors for invasive candidiasis. Materials and Methods: Patients with Candida species detected in clinical samples between January 2013 and December 2018 were included in this study. The demographic characteristics of the patients, the use of broad-spectrum antibiotics and immunosuppressive drugs, underlying diseases, blood transfusions, history of surgical operations, whether there is bacterial growth with Candida species in the same clinical sample, parenteral nutrition and invasive interventions were retrospectively analyzed and their relationship with invasive candidiasis was investigated. Results: A total of 91 patients were included in the study. The mean age was 72.3 ± 70.1 months. Among the patients 48.4% had Candida albicans while 51.6% had non-albicans Candida. Candida parapsilosis (n = 18, 19.8%) and Candida tropicalis (n = 14, 15.4%) were the most common non-albicans Candida species. The most common antifungal treatment was fluconazole (n = 34, 59.6%). There was no statistically significant relationship between invasive candidiasis and the underlying disease, central venous and / or urinary catheter, broad-spectrum antibiotic, corticosteroid, gender and surgical operation (p> 0.05). On the other hand, there was a statistically significant relationship between invasive candidiasis and parenteral nutrition, blood transfusion and bacterial growth with Candida species in the same clinical sample (p <0.05). Conclusions: Non-albicans Candida species are more common than Candida albicans in the pediatric intensive care units. Candida parapsilosis is the most common among non-albicans Candida species. Parenteral nutrition, blood transfusion and bacterial growth with Candida species in the same clinical sample increased the risk of invasive candidiasis.
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侵袭性念珠菌病的种类分布及危险因素
目的:本研究的目的是调查从儿童重症监护病房患者临床样本中分离的念珠菌种类,并确定侵袭性念珠菌病的危险因素。材料与方法:本研究纳入2013年1月至2018年12月临床样本中检出念珠菌的患者。回顾性分析患者的人口学特征、广谱抗生素和免疫抑制药物的使用情况、基础疾病、输血情况、手术史、同一临床样本中是否有念珠菌生长、肠外营养和有创干预等情况,并探讨其与侵袭性念珠菌病的关系。结果:共纳入91例患者。平均年龄72.3±70.1个月。其中白色念珠菌48.4%,非白色念珠菌51.6%。假丝酵母菌(n = 18, 19.8%)和热带假丝酵母菌(n = 14, 15.4%)是最常见的非白色念珠菌。最常见的抗真菌药物是氟康唑(n = 34, 59.6%)。侵袭性念珠菌感染与基础疾病、中心静脉和/或导尿管、广谱抗生素、皮质类固醇、性别和手术方式的关系无统计学意义(p < 0.05)。侵袭性念珠菌感染与同一临床样本的肠外营养、输血、细菌生长及念珠菌种类有统计学意义(p <0.05)。结论:在儿科重症监护病房,非白色念珠菌比白色念珠菌更常见。假丝酵母菌样假丝酵母菌是最常见的非白色念珠菌种。在同一临床样本中,肠外营养、输血和带有念珠菌的细菌生长增加了侵袭性念珠菌病的风险。
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