• Wan-Chen Chen, Pao-Yu Chen, Shun-Chen Yang, Ting-Yu Yen, Chun-Yi Lu, Jong-Min Chen, Ping-Ing Lee, Luan-Ying Chang, Yee-Chun Chen, and Li-Min Huang.
• Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pediatrics, Changhua Christian Children's Hospital, Changhua City, Taiwan.
• J Formos Med Assoc. 2022 Sep 1; 121 (9): 1668-1679.

Background/PurposeInvasive candidiasis is a severe infectious disease that could lead to mortality in critically ill children.MethodsWe collected data regarding demographics, underlying diseases, predisposing factors, outcomes for pediatric patients with candidemia at a medical centre in Taiwan from 2011 to 2017.ResultsFifty-eight patients with 60 candidemia episodes were diagnosed. The 3 most common species were Candida albicans (42%), Candida parapsilosis (25%) and Candida tropicalis (23%). C. parapsilosis predominantly infected infants and neonates (median age: 0.8 years, range: 0.1-14.5). Cases with C. tropicalis had significantly higher rates of multidrug resistance (p = 0.011) and disseminated candidiasis (p = 0.025) compared with other cases. The all-cause mortality rate was 43%, and the candidemia-related mortality rate was 29%. Pediatric sequential organ failure assessment score >8 [adjusted odds ratio (aOR) 66.2, 95% CI 4.03-1088.5] and posaconazole resistance (aOR 33.57, 95% CI 1.61-700.3) were the most significant risk factors associated with candidemia-related mortality, whereas treatment with effective antifungal agents within 48 h (aOR 0.07, 95% CI 0.01-0.9) was the only significant protective factor.ConclusionCandidemia-related mortality was related to azole resistance; therefore, empirical therapy with echinocandin or amphotericin B is recommended pending species and susceptibility results.Copyright © 2021. Published by Elsevier B.V.

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