Antifungal susceptibility, species distribution and risk factors associated with mortality of invasive candidiasis in children in Turkey: A six-year retrospective, single-centre study

Epidemiological indicators and predictors of lethality associated with fungal infections in a NICU: a historical series

OBJECTIVES

Fungal infections (FI) pose a public health concern and significantly increase mortality rates, especially within Neonatal Intensive Care Units (NICU). Thus, this study aimed to investigate epidemiological indicators, risk factors, and lethality predictors associated with FI in a NICU.

METHODS

This study included 1,510 neonates admitted to the NICU of a reference hospital in Brazil between 2015 and 2022. Demographic data, such as sex, birth weight, gestational age, and use of invasive devices were analyzed.

RESULTS

Thirty neonates developed invasive FI, totaling 33 episodes and an incidence of 1.2 per 1,000 patient days. Candida albicans was the most frequent species (52.9 %), the bloodstream was the most affected site (78.9 %), and 72.7 % of infections occurred between 2015 and 2018. The lethality rate associated with FI was 33.3 %, and 90 % of deaths occurred within 30 days of diagnosis of infection. Weight < 750 g, prolonged hospital stay, use of parenteral nutrition, and broad-spectrum antimicrobials were independent risk factors for infection occurrence, especially glycopeptides and 4th generation cephalosporins, having a considerable role in the increase in fungal infections. Weight < 750 g was considered a significant predictor of lethality, and C. albicans had the highest lethality rate (40 %).

CONCLUSION

These findings highlight the elevated lethality rate associated with these infections, reinforcing the importance of developing strategies to control FI within NICU.

Investigation of inflammation-related parameters in patients with candidemia hospitalized in the intensive care unit: A retrospective cohort study

BACKGROUND

Candidemia is the most common invasive fungal disease in intensive care units (ICUs).

OBJECTIVE

We aimed to investigate cases of candidemia infection developing in the ICU and factors associated with mortality due to this infection.

MATERIALS AND METHODS

This is a retrospective study including patients admitted to a tertiary university hospital ICU between January 2012 and December 2020. Patients over 18 years of age who had candida growth in at least one blood culture taken from central or peripheral samples (>48 h after admission to the ICU) without concurrent growth were evaluated.

RESULTS

The study group consisted of 136 patients with candida. Eighty-seven (63.97%) patients were male, with a median age of 69.5 (59-76.5) years. The 7-day mortality rate was 35.29%, while the 30-day mortality rate was 69.11%. As a result of multiple logistic regression analysis, after adjusting for age and malignancy, high APACHE II score and low platelet-lymphocyte ratio (PLR) - were found to be significant factors in predicting both 7-day and 30-day mortality.

CONCLUSION

In this study, PLR and APACHE II scores were shown to be independent predictors of mortality in patients with candidemia in the ICU.