Breakthrough candidemia in children: Clinical and microbiological characteristics, therapeutic strategies and impact on outcomes

Mei Yin Lai, Jen Fu Hsu, Shih Ming Chu, I. Hsyuan Wu, Hsuan Rong Huang, Chun Chih Lin, I-Ta Lee, Ming Chou Chiang, Ren Huei Fu, Ming Horng Tsai

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Aim: To assess the characteristics, treatments, risk factors and outcomes of breakthrough candidemia in children. Materials & methods: Episodes of breakthrough candidemia in children were compared with the remaining episodes in a 13-year cohort study. Results: Out of 319 episodes, 45 (14.1%) were breakthrough candidemia. Breakthrough candidemia occurred in patients with more acutely ill conditions, and the majority was caused by non-albicans Candida species (73.3%; 33 episodes). A total of 79.1% of breakthrough candidemia were caused by antifungal-susceptible Candida isolates and emergence of resistance was the mechanism in five cases of patients receiving fluconazole. Episodes of breakthrough candidemia had significantly higher illness severity and higher rates of fungemia-attributable mortality. Conclusion: Breakthrough candidemia independently contributed to unfavorable outcomes, and more aggressive treatment strategies are warranted when breakthrough candidemia is encountered.

Original languageEnglish
Pages (from-to)695-705
Number of pages11
JournalFuture Microbiology
Volume12
Issue number8
DOIs
Publication statusPublished - Jun 1 2017
Externally publishedYes

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Keywords

  • antifungal susceptibility
  • bloodstream infection
  • candidemia
  • invasive candidiasis
  • mortality

ASJC Scopus subject areas

  • Microbiology
  • Microbiology (medical)

Cite this

Lai, M. Y., Hsu, J. F., Chu, S. M., Wu, I. H., Huang, H. R., Lin, C. C., Lee, I-T., Chiang, M. C., Fu, R. H., & Tsai, M. H. (2017). Breakthrough candidemia in children: Clinical and microbiological characteristics, therapeutic strategies and impact on outcomes. Future Microbiology, 12(8), 695-705. https://doi.org/10.2217/fmb-2016-0223