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

Abstract

Introduction. Candida species are the main causative agent of fungal infections in the pediatric population, especially in neonates and intensive care unit patients. Invasive candidiasis is associated with unfavorable clinical outcomes such as prolonged hospitalization time and mortality.
Objective. To describe demographic, clinical characteristics and mortality of pediatric patients (older than 1 month, younger than 18 years old) hospitalized in a PICU with a diagnosis of invasive candidiasis (IC) within a 9-year period (2012-2020).
Materials and methods. Retrospective observational cohort study conducted at a high-complexity center in southwestern Colombia.
Results. We included 100 pediatric patients diagnosed with IC, 51% female with a median age of 6.5 years (Interquartile Range (IQR) 2-11.5). A total of 114 isolates of Candida spp. were obtained. The median hospital stay was 51 days (IQR 29-77), with a PICU 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 the bloodstream (49.1%), followed by respiratory samples (21.9%) and peritoneal fluid (20.2%). The most frequently isolated species was 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 PICUs, IC is a common condition that represents a significant challenge due to its high morbidity, prolonged hospital stay, and considerable mortality rate. While C. albicans remains the predominant species, there is a growing trend towards non-albicans Candida species, showing new diagnostic and therapeutic challenges.