Not just little adults: candidemia epidemiology, molecular characterization, and antifungal susceptibility in neonatal and pediatric patients

C C Blyth, S. C. Chen, M A Slavin, C Serena, Quoc Nguyen, Deborah Marriott, David Ellis, W. Meyer, T C Sorrell, Steven Wesselingh

Research output: Chapter in Book/Report/Conference proceedingChapter

108 Citations (Scopus)

Abstract

OBJECTIVE: The purpose of this work was to identify differences in incidence, risk factors, microbiology, treatment, and clinical outcome of candidemia in neonates, children, and adults that might impact on management. PATIENTS AND METHODS: Cases of candidemia in Australia were identified prospectively by blood culture surveillance over 3 years. Episodes of candidemia in neonatal, pediatric, and adult age groups were analyzed and compared. RESULTS: Of 1005 incident cases, 33 occurred in neonates, 110 in children, and 862 in adults. The respective annual age-specific incidences were 4.4, 0.9, and 1.8 per 100,000 population. Prematurity and ICU admission were major risk factors in neonates. Hematologic malignancy and neutropenia were significantly more frequent in children than in neonates and adults. Diabetes, renal disease, hemodialysis, and recent surgery were more common in adults. Candidemia was attributed to a vascular access device in 58% of neonates, 70% of children, and 44% of adults. Candida albicans caused approximately 48% of cases in all of the age groups. Candida parapsilosis was significantly more common in neonates and children (42% and 38% vs 15%). Candida glabrata was infrequent in neonates and children (9% and 3% vs 17%). Significantly more isolates from children were susceptible to fluconazole compared with those from adults (95% vs 75%). Fluconazole-resistant candidal isolates were infrequent in all of the age groups. Neonates and children were more likely to receive amphotericin B compared with adults. Adults were more likely to receive fluconazole. Survival rates at 30 days were 78% in neonates, 90% in children, and 70% in adults. CONCLUSIONS: This study identifies significant differences in candidemia in neonates, children, and adults. Neonatologists and pediatricians must consider age-specific differences when interpreting adult studies and developing treatment and prevention guidelines
LanguageEnglish
Title of host publicationPediatrics
Place of PublicationCentre for Infectious Diseases and Microbiology, Westmead Hospital, Hawkesbury Road, Westmend, New South Wales 2145, Australia. christopher.blyth@swahs.health.nsw.gov.au
Pages1360-1368
Number of pages9
DOIs
Publication statusPublished - May 2009

Publication series

NamePediatrics
Volume123

Keywords

  • Adult
  • Amphotericin B
  • Antifungal Agents
  • Australia
  • Candida
  • Candida albicans
  • Candidiasis
  • Child
  • Child,Preschool
  • Comorbidity
  • DNA Fingerprinting
  • Female
  • Fluconazole
  • Humans
  • Incidence
  • Infant,Newborn
  • Infant,Premature
  • Male
  • Neoplasms
  • Neutropenia
  • Risk Factors
  • Seroepidemiologic Studies
  • Survival Rate
  • Systemic Inflammatory Response Syndrome
  • blood
  • drug therapy
  • epidemiology
  • genetics
  • microbiology
  • mortality
  • therapeutic use

Cite this

Blyth, C. C., Chen, S. C., Slavin, M. A., Serena, C., Nguyen, Q., Marriott, D., ... Wesselingh, S. (2009). Not just little adults: candidemia epidemiology, molecular characterization, and antifungal susceptibility in neonatal and pediatric patients. In Pediatrics (pp. 1360-1368). (Pediatrics; Vol. 123). Centre for Infectious Diseases and Microbiology, Westmead Hospital, Hawkesbury Road, Westmend, New South Wales 2145, Australia. christopher.blyth@swahs.health.nsw.gov.au. https://doi.org/123/5/1360 [pii]\r10.1542/peds.2008-2055
Blyth, C C ; Chen, S. C. ; Slavin, M A ; Serena, C ; Nguyen, Quoc ; Marriott, Deborah ; Ellis, David ; Meyer, W. ; Sorrell, T C ; Wesselingh, Steven. / Not just little adults: candidemia epidemiology, molecular characterization, and antifungal susceptibility in neonatal and pediatric patients. Pediatrics. Centre for Infectious Diseases and Microbiology, Westmead Hospital, Hawkesbury Road, Westmend, New South Wales 2145, Australia. christopher.blyth@swahs.health.nsw.gov.au, 2009. pp. 1360-1368 (Pediatrics).
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abstract = "OBJECTIVE: The purpose of this work was to identify differences in incidence, risk factors, microbiology, treatment, and clinical outcome of candidemia in neonates, children, and adults that might impact on management. PATIENTS AND METHODS: Cases of candidemia in Australia were identified prospectively by blood culture surveillance over 3 years. Episodes of candidemia in neonatal, pediatric, and adult age groups were analyzed and compared. RESULTS: Of 1005 incident cases, 33 occurred in neonates, 110 in children, and 862 in adults. The respective annual age-specific incidences were 4.4, 0.9, and 1.8 per 100,000 population. Prematurity and ICU admission were major risk factors in neonates. Hematologic malignancy and neutropenia were significantly more frequent in children than in neonates and adults. Diabetes, renal disease, hemodialysis, and recent surgery were more common in adults. Candidemia was attributed to a vascular access device in 58{\%} of neonates, 70{\%} of children, and 44{\%} of adults. Candida albicans caused approximately 48{\%} of cases in all of the age groups. Candida parapsilosis was significantly more common in neonates and children (42{\%} and 38{\%} vs 15{\%}). Candida glabrata was infrequent in neonates and children (9{\%} and 3{\%} vs 17{\%}). Significantly more isolates from children were susceptible to fluconazole compared with those from adults (95{\%} vs 75{\%}). Fluconazole-resistant candidal isolates were infrequent in all of the age groups. Neonates and children were more likely to receive amphotericin B compared with adults. Adults were more likely to receive fluconazole. Survival rates at 30 days were 78{\%} in neonates, 90{\%} in children, and 70{\%} in adults. CONCLUSIONS: This study identifies significant differences in candidemia in neonates, children, and adults. Neonatologists and pediatricians must consider age-specific differences when interpreting adult studies and developing treatment and prevention guidelines",
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Blyth, CC, Chen, SC, Slavin, MA, Serena, C, Nguyen, Q, Marriott, D, Ellis, D, Meyer, W, Sorrell, TC & Wesselingh, S 2009, Not just little adults: candidemia epidemiology, molecular characterization, and antifungal susceptibility in neonatal and pediatric patients. in Pediatrics. Pediatrics, vol. 123, Centre for Infectious Diseases and Microbiology, Westmead Hospital, Hawkesbury Road, Westmend, New South Wales 2145, Australia. christopher.blyth@swahs.health.nsw.gov.au, pp. 1360-1368. https://doi.org/123/5/1360 [pii]\r10.1542/peds.2008-2055

Not just little adults: candidemia epidemiology, molecular characterization, and antifungal susceptibility in neonatal and pediatric patients. / Blyth, C C; Chen, S. C.; Slavin, M A; Serena, C; Nguyen, Quoc; Marriott, Deborah; Ellis, David; Meyer, W.; Sorrell, T C; Wesselingh, Steven.

Pediatrics. Centre for Infectious Diseases and Microbiology, Westmead Hospital, Hawkesbury Road, Westmend, New South Wales 2145, Australia. christopher.blyth@swahs.health.nsw.gov.au, 2009. p. 1360-1368 (Pediatrics; Vol. 123).

Research output: Chapter in Book/Report/Conference proceedingChapter

TY - CHAP

T1 - Not just little adults: candidemia epidemiology, molecular characterization, and antifungal susceptibility in neonatal and pediatric patients

AU - Blyth, C C

AU - Chen, S. C.

AU - Slavin, M A

AU - Serena, C

AU - Nguyen, Quoc

AU - Marriott, Deborah

AU - Ellis, David

AU - Meyer, W.

AU - Sorrell, T C

AU - Wesselingh, Steven

PY - 2009/5

Y1 - 2009/5

N2 - OBJECTIVE: The purpose of this work was to identify differences in incidence, risk factors, microbiology, treatment, and clinical outcome of candidemia in neonates, children, and adults that might impact on management. PATIENTS AND METHODS: Cases of candidemia in Australia were identified prospectively by blood culture surveillance over 3 years. Episodes of candidemia in neonatal, pediatric, and adult age groups were analyzed and compared. RESULTS: Of 1005 incident cases, 33 occurred in neonates, 110 in children, and 862 in adults. The respective annual age-specific incidences were 4.4, 0.9, and 1.8 per 100,000 population. Prematurity and ICU admission were major risk factors in neonates. Hematologic malignancy and neutropenia were significantly more frequent in children than in neonates and adults. Diabetes, renal disease, hemodialysis, and recent surgery were more common in adults. Candidemia was attributed to a vascular access device in 58% of neonates, 70% of children, and 44% of adults. Candida albicans caused approximately 48% of cases in all of the age groups. Candida parapsilosis was significantly more common in neonates and children (42% and 38% vs 15%). Candida glabrata was infrequent in neonates and children (9% and 3% vs 17%). Significantly more isolates from children were susceptible to fluconazole compared with those from adults (95% vs 75%). Fluconazole-resistant candidal isolates were infrequent in all of the age groups. Neonates and children were more likely to receive amphotericin B compared with adults. Adults were more likely to receive fluconazole. Survival rates at 30 days were 78% in neonates, 90% in children, and 70% in adults. CONCLUSIONS: This study identifies significant differences in candidemia in neonates, children, and adults. Neonatologists and pediatricians must consider age-specific differences when interpreting adult studies and developing treatment and prevention guidelines

AB - OBJECTIVE: The purpose of this work was to identify differences in incidence, risk factors, microbiology, treatment, and clinical outcome of candidemia in neonates, children, and adults that might impact on management. PATIENTS AND METHODS: Cases of candidemia in Australia were identified prospectively by blood culture surveillance over 3 years. Episodes of candidemia in neonatal, pediatric, and adult age groups were analyzed and compared. RESULTS: Of 1005 incident cases, 33 occurred in neonates, 110 in children, and 862 in adults. The respective annual age-specific incidences were 4.4, 0.9, and 1.8 per 100,000 population. Prematurity and ICU admission were major risk factors in neonates. Hematologic malignancy and neutropenia were significantly more frequent in children than in neonates and adults. Diabetes, renal disease, hemodialysis, and recent surgery were more common in adults. Candidemia was attributed to a vascular access device in 58% of neonates, 70% of children, and 44% of adults. Candida albicans caused approximately 48% of cases in all of the age groups. Candida parapsilosis was significantly more common in neonates and children (42% and 38% vs 15%). Candida glabrata was infrequent in neonates and children (9% and 3% vs 17%). Significantly more isolates from children were susceptible to fluconazole compared with those from adults (95% vs 75%). Fluconazole-resistant candidal isolates were infrequent in all of the age groups. Neonates and children were more likely to receive amphotericin B compared with adults. Adults were more likely to receive fluconazole. Survival rates at 30 days were 78% in neonates, 90% in children, and 70% in adults. CONCLUSIONS: This study identifies significant differences in candidemia in neonates, children, and adults. Neonatologists and pediatricians must consider age-specific differences when interpreting adult studies and developing treatment and prevention guidelines

KW - Adult

KW - Amphotericin B

KW - Antifungal Agents

KW - Australia

KW - Candida

KW - Candida albicans

KW - Candidiasis

KW - Child

KW - Child,Preschool

KW - Comorbidity

KW - DNA Fingerprinting

KW - Female

KW - Fluconazole

KW - Humans

KW - Incidence

KW - Infant,Newborn

KW - Infant,Premature

KW - Male

KW - Neoplasms

KW - Neutropenia

KW - Risk Factors

KW - Seroepidemiologic Studies

KW - Survival Rate

KW - Systemic Inflammatory Response Syndrome

KW - blood

KW - drug therapy

KW - epidemiology

KW - genetics

KW - microbiology

KW - mortality

KW - therapeutic use

U2 - 123/5/1360 [pii]\r10.1542/peds.2008-2055

DO - 123/5/1360 [pii]\r10.1542/peds.2008-2055

M3 - Chapter

SN - 1098-4275 (Electronic)\r0031-4005 (Linking)

T3 - Pediatrics

SP - 1360

EP - 1368

BT - Pediatrics

CY - Centre for Infectious Diseases and Microbiology, Westmead Hospital, Hawkesbury Road, Westmend, New South Wales 2145, Australia. christopher.blyth@swahs.health.nsw.gov.au

ER -

Blyth CC, Chen SC, Slavin MA, Serena C, Nguyen Q, Marriott D et al. Not just little adults: candidemia epidemiology, molecular characterization, and antifungal susceptibility in neonatal and pediatric patients. In Pediatrics. Centre for Infectious Diseases and Microbiology, Westmead Hospital, Hawkesbury Road, Westmend, New South Wales 2145, Australia. christopher.blyth@swahs.health.nsw.gov.au. 2009. p. 1360-1368. (Pediatrics). https://doi.org/123/5/1360 [pii]\r10.1542/peds.2008-2055