Active Surveillance of Candidemia in Children from Latin America A Key Requirement for Improving Disease Outcome

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dc.contributor.authorSantolaya, Maria E.
dc.contributor.authorAlvarado, Tito
dc.contributor.authorQueiroz-Telles, Flavio
dc.contributor.authorColombo, Arnaldo L. [UNIFESP]
dc.contributor.authorZurita, Jeanette
dc.contributor.authorTiraboschi, Iris N.
dc.contributor.authorAlberto Cortes, Jorge
dc.contributor.authorThompson, Luis
dc.contributor.authorGuzman, Manuel
dc.contributor.authorSifuentes, Jose
dc.contributor.authorEchevarria, Juan I.
dc.contributor.authorNucci, Marcio
dc.contributor.authorLatin Amer Invasive Mycosis Networ
dc.contributor.institutionUniv Chile
dc.contributor.institutionHosp Escuela Tegucigalpa
dc.contributor.institutionUniv Fed Parana
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionPontificia Univ Catolica Ecuador
dc.contributor.institutionHosp Clin Jose San Martin
dc.contributor.institutionUniv Nacl Colombia
dc.contributor.institutionUniv Desarrollo
dc.contributor.institutionHosp Vargas Caracas
dc.contributor.institutionInst Nacl Ciencias Med & Nutr Salvador Zubiran
dc.contributor.institutionUniv Cayetano Heredia
dc.contributor.institutionUniversidade Federal do Rio de Janeiro (UFRJ)
dc.date.accessioned2016-01-24T14:35:17Z
dc.date.available2016-01-24T14:35:17Z
dc.date.issued2014-02-01
dc.description.abstractBackground: Active surveillance is necessary for improving the management and outcomes of patients with candidemia. the aim of this study was to describe the epidemiologic and clinical features of candidemia in pediatric patients in Latin America.Method: Prospective, multicenter, surveillance study of candidemia in a pediatric population from 23 hospitals in 8 Latin America countries between November 2008 and October 2010.Results: Three hundred and two cases of candidemia were reported with a median incidence of 0.81/1000 admissions. Eighty nine (29%) were neonates. the main risk factors were prematurity, intensive care unit (ICU) admission, parenteral nutrition, respiratory disease and mechanical ventilation in neonates and malignancy, neutropenia, neurological disease and previous use of corticosteroids in children. the main species isolated in neonates and children were Candida albicans (43.8% and 35.7%), Candida parapsilosis (27.0% and 26.3%) and Candida tropicalis (14.6% and 14.6%), respectively. the most frequent antifungal therapy used in neonates and children was deoxycholate-amphotericin-B (43.8% and 29.1%) and fluconazole (28.1% and 53.1%). Seventeen neonates (19.1%) and 20 children (9.4%) did not receive antifungal therapy. the 30-day survival rate was 60% in neonates and 72% in children (P = 0.02). Survival was significantly higher in treated than in nontreated neonates (72% vs. 24%; P < 0.001). A multivariate analysis showed that independent predictors for 30-day mortality in children were renal disease (odds ratio: 4.38, 95% confidence interval: 1.92-10.1, P < 0.001) and receipt of corticosteroids (odds ratio: 2.08, 95% confidence interval: 1.04-4.17, P = 0.04).Conclusions: To our knowledge, this is the first prospective, multicenter surveillance study of candidemia in children in Latin America. This epidemiologic information may provide us with methods to improve preventive, diagnostic and therapeutic strategies in our continent.en
dc.description.affiliationUniv Chile, Fac Med, Hosp Luis Calvo Mackenna, Dept Pediat, Santiago 7, Chile
dc.description.affiliationHosp Escuela Tegucigalpa, Tegucigalpa, Honduras
dc.description.affiliationUniv Fed Parana, Hosp Clin, BR-80060000 Curitiba, Parana, Brazil
dc.description.affiliationUniversidade Federal de São Paulo, Escola Paulista Med, Infect Dis Unit, São Paulo, Brazil
dc.description.affiliationPontificia Univ Catolica Ecuador, Hosp Vozandes, Fac Med, Quito, Ecuador
dc.description.affiliationHosp Clin Jose San Martin, Buenos Aires, DF, Argentina
dc.description.affiliationUniv Nacl Colombia, Dept Internal Med, Bogota, Colombia
dc.description.affiliationUniv Desarrollo, Dept Med, Clin Alemana, Infect Dis Unit, Santiago, Chile
dc.description.affiliationHosp Vargas Caracas, Infect Unit, Caracas, Venezuela
dc.description.affiliationInst Nacl Ciencias Med & Nutr Salvador Zubiran, Mexico City, DF, Mexico
dc.description.affiliationUniv Cayetano Heredia, Dept Med, Lima, Peru
dc.description.affiliationUniv Fed Rio de Janeiro, Univ Hosp, Rio de Janeiro, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Escola Paulista Med, Infect Dis Unit, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipPfizer Inc.
dc.format.extentE40-E44
dc.identifierhttp://dx.doi.org/10.1097/INF.0000000000000039
dc.identifier.citationPediatric Infectious Disease Journal. Philadelphia: Lippincott Williams & Wilkins, v. 33, n. 2, p. E40-E44, 2014.
dc.identifier.doi10.1097/INF.0000000000000039
dc.identifier.issn0891-3668
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/37411
dc.identifier.wosWOS:000331139100003
dc.language.isoeng
dc.publisherLippincott Williams & Wilkins
dc.relation.ispartofPediatric Infectious Disease Journal
dc.rightsAcesso restrito
dc.subjectCandidemiaen
dc.subjectChildrenen
dc.subjectLatin Americaen
dc.subjectepidemiologyen
dc.titleActive Surveillance of Candidemia in Children from Latin America A Key Requirement for Improving Disease Outcomeen
dc.typeArtigo
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