Epidemiological characteristics of pediatric patients with invasive candidiasis in an intensive care unit in southwestern Colombia

Abstract

Introduction. Candida species are the main etiological agent of fungal infections in the pediatric population, especially in neonates and in intensive care unit patients. Invasive candidiasis is associated with unfavorable clinical outcomes, such as prolonged hospitalization time, and mortality. Objective. To describe demographic, clinical and microbiological characteristics of pediatric patients (older than one month and younger than 18 years) hospitalized in a pediatric intensive care unit with a diagnosis of invasive candidiasis between 2012 and 2020. Materials and methods. A retrospective, observational, cohort study was conducted at a high-complexity center in southwestern Colombia. Results. We included 100 pediatric patients diagnosed with invasive candidiasis, 51% female with a median age of 6.5 years (IQR = 2-11.5). We obtained 114 isolates of Candida spp. The median hospital stay was 51 days (IQR = 29-77), with a pediatric intensive care unit stay of 27 days (IQR = 16-58). Tachycardia was present in 85% of the patients 24 hours before Candida spp. isolation. Nearly half of the isolates were found in bloodstream samples (49.1%), respiratory samples (21.9%), and peritoneal fluid (20.2%). The most frequently isolated species were C. albicans (36.8%), followed by non-albicans species, such as C. parapsilosis (22.8%), and C. tropicalis (21.1%). The overall mortality rate at discharge was 36%. Conclusions. In pediatric intensive care units, invasive candidiasis is a common condition representing a significant threat due to its high morbidity, prolonged hospital stay, and considerable mortality rate. While C. albicans remains as the predominant species, non-albicans Candida species exhibit a growing trend, posing new diagnostic and therapeutic challenges.