Journal Article

Risk Factors for Candidemia in a Children's Hospital

Laurie MacDonald, Carol Baker and Carol Chenoweth

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 26, issue 3, pages 642-645
Published in print March 1998 | ISSN: 1058-4838
Published online March 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/514580
Risk Factors for Candidemia in a Children's Hospital

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Candida species are increasingly important nosocomial pathogens in critically ill children. A 2.3- fold increase in the rate of nosocomial candidemia at our 200-bed tertiary care children's hospital prompted a study to identify risk factors for this infection. Twenty-six cases were identified between 1992 and 1993, representing 21% of all nosocomial bloodstream infections. Candida albicans was the most frequent isolate (58%), followed by Candida parapsilosis (27%). A case-control study revealed that there was a statistically significant association between the occurrence of candidemia and placement of a central venous catheter in the femoral vein (P = .03), the use of a tunneled central venous catheter (P = .05), and prolonged hyperalimentation (P = .04). Patients with candidemia also were noted to have candiduria more often than controls (P = .003) and were more likely to have had topical antifungal agents prescribed (P = .04). Multivariate analysis showed that hyperalimentation was an independent risk factor for the development of candidemia. We conclude that measures must be taken to reduce these risk factors whenever possible.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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