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Epidemiology of Culture-confirmed Candidemia Among Hospitalized Children in South Africa, 2012-2017.
Shuping, Liliwe; Mpembe, Ruth; Mhlanga, Mabatho; Naicker, Serisha D; Maphanga, Tsidiso G; Tsotetsi, Ernest; Wadula, Jeannette; Velaphi, Sithembiso; Nakwa, Firdose; Chibabhai, Vindana; Mahabeer, Prasha; Moncho, Masego; Prentice, Elizabeth; Bamford, Colleen; Reddy, Kessendri; Maluleka, Caroline; Mawela, Dini; Modise, Motshabi; Govender, Nelesh P.
Afiliação
  • Shuping L; From the Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa.
  • Mpembe R; From the Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa.
  • Mhlanga M; From the Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa.
  • Naicker SD; School of Molecular and Cell Biology, Faculty of Science, University of the Witwatersrand, Johannesburg, South Africa.
  • Maphanga TG; From the Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa.
  • Tsotetsi E; Department of Clinical Microbiology and Infectious Diseases, School of Pathology, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
  • Wadula J; From the Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa.
  • Velaphi S; Department of Clinical Microbiology and Infectious Diseases, School of Pathology, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
  • Nakwa F; From the Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa.
  • Chibabhai V; Department of Clinical Microbiology and Infectious Diseases, School of Pathology, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
  • Mahabeer P; Department of Microbiology, National Health Laboratory Service, Chris Hani Baragwanath Hospital, Johannesburg, South Africa.
  • Moncho M; Department of Paediatrics and Child Health, Chris Hani Baragwanath Hospital, Johannesburg, South Africa.
  • Prentice E; Department of Paediatrics and Child Health, Chris Hani Baragwanath Hospital, Johannesburg, South Africa.
  • Bamford C; Department of Clinical Microbiology and Infectious Diseases, School of Pathology, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
  • Reddy K; Department of Microbiology, National Health Laboratory Service, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa.
  • Maluleka C; Department of Microbiology, National Health Laboratory Service, King Edward VIII Hospital, KZN Academic Complex, Durban, South Africa.
  • Mawela D; Department of Medical Microbiology, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
  • Modise M; Department of Medical Microbiology, Faculty of Health Sciences, Universitas Hospital, National Health Laboratory Service, University of Free State, Bloemfontein, South Africa.
  • Govender NP; Division of Medical Microbiology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Pediatr Infect Dis J ; 40(8): 730-737, 2021 08 01.
Article em En | MEDLINE | ID: mdl-33872278
ABSTRACT

BACKGROUND:

We aimed to describe the epidemiology of candidemia among children in South Africa.

METHODS:

We conducted laboratory-based surveillance among neonates (≤28 days), infants (29 days to <1 year), children (1-11 years) and adolescents (12-17 years) with Candida species cultured from blood during 2012-2017. Identification and antifungal susceptibility of viable isolates were performed at a reference laboratory. We used multivariable logistic regression to determine the association between Candida parapsilosis candidemia and 30-day mortality among neonates.

RESULTS:

Of 2996 cases, neonates accounted for 49% (n = 1478), infants for 27% (n = 806), children for 20% (n = 589) and adolescents for 4% (n = 123). The incidence risk at tertiary public sector hospitals was 5.3 cases per 1000 pediatric admissions (range 0.39-119.1). Among 2943 cases with single-species infections, C. parapsilosis (42%) and Candida albicans (36%) were most common. Candida auris was among the 5 common species with an overall prevalence of 3% (n = 47). Fluconazole resistance was more common among C. parapsilosis (55% [724/1324]) versus other species (19% [334/1737]) (P < 0.001). Of those with known treatment (n = 1666), 35% received amphotericin B deoxycholate alone, 32% fluconazole alone and 30% amphotericin B deoxycholate with fluconazole. The overall 30-day in-hospital mortality was 38% (n = 586) and was highest among neonates (43% [323/752]) and adolescents (43% [28/65]). Compared with infection with other species, C. parapsilosis infection was associated with a reduced mortality among neonates (adjusted odds ratio 0.41, 95% confidence interval 0.22-0.75, P = 0.004).

CONCLUSIONS:

Candidemia in this setting mainly affected neonates and infants and was characterized by fluconazole-resistant C. parapsilosis with no increased risk of death.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Candida / Criança Hospitalizada / Candidemia Tipo de estudo: Clinical_trials / Incidence_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Newborn País/Região como assunto: Africa Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Candida / Criança Hospitalizada / Candidemia Tipo de estudo: Clinical_trials / Incidence_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Newborn País/Região como assunto: Africa Idioma: En Ano de publicação: 2021 Tipo de documento: Article