545 - Clinical Epidemiology of Candidemia in Hospitalized Children

Poster Number: 545
Publication Number: 545.328

Rishika Bheem, George Washington University School of Medicine and Health Sciences, Washington, DC, United States; Benjamin Hanisch, Children's National Health System, Washington, DC, United States; Emily Ansusinha, Children's National Health System, Washington, DC, United States; Rana F. Hamdy, Children's National Health System, Washingtotn, DC, United States

Background: Candidemia is the most common invasive fungal infection in hospitalized children, and the third most common cause of pediatric nosocomial bloodstream infections. The distribution of species of Candida causing bloodstream infections in hospitalized children has shifted over time, as have the resistance patterns to anti-fungal drugs. 

Objective: The objective of this study is to investigate the epidemiology including the species distribution and susceptibility patterns for Candida bloodstream infections. 

Design/Methods: This retrospective cohort study analyzed all patients < 21 years of age with a positive blood culture for Candida admitted to Children’s National Hospital between January 1, 2010, and December 31, 2020. Demographic features, baseline clinical characteristics, Candida species and susceptibilities, and duration of fungemia for yeast were collected from the electronic health records through structured chart review.

Results: One-hundred episodes of Candida (94 patients) were included in this study. The mean age of patients in the cohort was 5.81 ± 6.51 years (Table). The mean duration of admission was 57.15 days ± 64.69. Further, 46% of episodes were admitted to critical care units, while 16% were admitted to the hematology/oncology/bone marrow transplant unit, and 12% were admitted to the intestinal rehabilitation unit. Sixty-two percent of episodes were hospital-acquired and 52% of episodes were definitively deemed a central-line associated bloodstream infection (CLABSI). C. parapsilosis/guilliermondii were the most commonly identified species (44), followed by C. albicans (38), C. lusitaniae (8), C. tropicalis (7), C. krusei (2), C. famata (1), and C. glabrata (1). Ninety-four percent of isolates showed susceptibility to fluconazole, with six episodes showing resistance: C. krusei (2), C. glabrata (1), C. parapsilosis/guilliermondii (1), C. tropicalis (1), and C. albicans (1). Conclusion(s): Candida bloodstream infections occurred most frequently in critically ill children admitted in the intensive care unit, and more than half were determined to be CLABSIs. The vast majority of isolates were susceptible to fluconazole.  
Rishika Bheem CV for PAS Jan 2022.pdf