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Aim <p>Invasive candidiasis is a major contributor to morbidity and mortality in hospitalized children, particularly in those with comorbidities or prolonged hospitalizations. This study evaluated the epidemiology, antifungal susceptibility, and outcomes of invasive <i>Candida</i> infections over an 11-year period.</p> Methods <p>A retrospective study was conducted at Hacettepe University Children’s Hospital from 2013 to 2024. Pediatric patients with culture-confirmed invasive <i>Candida</i> infections were included. Data on species distribution, antifungal susceptibility, and clinical outcomes were analyzed.</p> Results <p>A total of 158 invasive candidiasis episodes were identified, yielding 166 <i>Candida</i> isolates. <i>Candida albicans</i> was most common (40.3%), followed by <i>Candida parapsilosis</i> SC (24.1%), <i>Nakaseomyces glabratus</i> (7.8%), <i>Candida tropicalis</i> (7.8%), <i>Clavispora lusitaniae</i> (7.2%), and others (12%). Candidemia accounted for 89.9% of cases; less common manifestations included meningitis, peritonitis, endocarditis, and pneumonia. Over time, <i>C. albicans</i> cases declined, while <i>C. parapsilosis</i> SC remained the predominant non-albicans species. Fluconazole resistance was highest in <i>C. parapsilosis</i> SC (13.2%). Overall mortality was 35.4%, with 14.6% directly attributed to invasive candidiasis. Catheter removal significantly reduced mortality (OR = 8.44, 95% CI: 2.81–25.3, <i>p</i> &lt; 0.001).</p> Conclusions <p>Non-albicans Candida species became increasingly prevalent, while <i>C. albicans</i> declined. Mortality significantly decreased, likely due to improved patient management. Rising azole resistance in <i>C. parapsilosis</i> SC and the benefit of early catheter removal highlight the need for timely, species-specific strategies.</p>

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Trends in Pediatric Invasive Candidiasis: Shifting Species Distribution and Improving Outcomes

  • 期刊论文

  • 发表日期：

    2025年11月5日

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  • Kubra Aykac,
  • Emine Gulfem Anac,
  • Bera Enes Seyrek,
  • Azer Karaman,
  • Osman Oguz Demir,
  • Tugce Unalan-Altintop,
  • Dolunay Gulmez,
  • Sevtap Arikan-Akdagli,
  • Hanife Avci,
  • Ali Bulent Cengiz,
  • Yasemin Ozsurekci

摘要

Aim

Invasive candidiasis is a major contributor to morbidity and mortality in hospitalized children, particularly in those with comorbidities or prolonged hospitalizations. This study evaluated the epidemiology, antifungal susceptibility, and outcomes of invasive Candida infections over an 11-year period.

Methods

A retrospective study was conducted at Hacettepe University Children’s Hospital from 2013 to 2024. Pediatric patients with culture-confirmed invasive Candida infections were included. Data on species distribution, antifungal susceptibility, and clinical outcomes were analyzed.

Results

A total of 158 invasive candidiasis episodes were identified, yielding 166 Candida isolates. Candida albicans was most common (40.3%), followed by Candida parapsilosis SC (24.1%), Nakaseomyces glabratus (7.8%), Candida tropicalis (7.8%), Clavispora lusitaniae (7.2%), and others (12%). Candidemia accounted for 89.9% of cases; less common manifestations included meningitis, peritonitis, endocarditis, and pneumonia. Over time, C. albicans cases declined, while C. parapsilosis SC remained the predominant non-albicans species. Fluconazole resistance was highest in C. parapsilosis SC (13.2%). Overall mortality was 35.4%, with 14.6% directly attributed to invasive candidiasis. Catheter removal significantly reduced mortality (OR = 8.44, 95% CI: 2.81–25.3, p < 0.001).

Conclusions

Non-albicans Candida species became increasingly prevalent, while C. albicans declined. Mortality significantly decreased, likely due to improved patient management. Rising azole resistance in C. parapsilosis SC and the benefit of early catheter removal highlight the need for timely, species-specific strategies.