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J. Fungi 2019, 5(1), 19;

Changing Epidemiology of Invasive Candidiasis in Children during a 10-Year Period

First Department of Pediatrics, Division of Infectious Diseases, “Aghia Sophia” Children’s Hospital, National and Kapodistrian University of Athens, 115 27 Athens, Greece
Department of Microbiology, “Aghia Sophia” Children’s Hospital, 115 27 Athens, Greece
Department of Microbiology, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece
Author to whom correspondence should be addressed.
Received: 29 December 2018 / Revised: 15 February 2019 / Accepted: 21 February 2019 / Published: 22 February 2019
(This article belongs to the Special Issue Fungal Epidemiology)
PDF [237 KB, uploaded 22 February 2019]


Candida species are a common cause of invasive infection in neonates and children. The aim of our study was to evaluate the epidemiology and microbiology of invasive candidiasis (IC) in the largest tertiary Greek pediatric hospital during a 10-year period. A retrospective cohort study was performed from January 2008 to December 2017. Identification of species and antifungal susceptibility testing was performed according to the Clinical and Laboratory Standards Institute (CLSI) methodology. During the study period, 178 cases of IC were recorded. The tissue distribution included blood (87.1%), cerebrospinal (7.9%), peritoneal (3.9%) and pleural fluids (1.1%). Candida albicans and Candida parapsilosis (sensu lato) were the most frequently isolated species (47.8% and 28.7% respectively). From period 2008–2012 to period 2013–2017, a significant decrease in IC rates was detected (0.21 cases/1000 hospitalization days VS 0.11 cases/1000 hospitalization days, P = 0.040), while median minimum inhibitory concentrations (MICs) of amphotericin B were significantly increased for both C. albicans and C. parapsilosis (sl) (P = 0.037 and P = 0.004 respectively). The decrease in IC rates may reflect the increased awareness as well as the effective infection control initiatives and antifungal interventions. However, the significant increase in the MICs for amphotericin B and echinocandins such as caspofungin, raises concerns about their common use as first-line treatment. Epidemiologic monitoring is, therefore, critically important in order to evaluate and optimize therapeutic protocols for IC in pediatric populations. View Full-Text
Keywords: candidiasis; invasive; antifungal; children; resistance candidiasis; invasive; antifungal; children; resistance
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Noni, M.; Stathi, A.; Vaki, I.; Velegraki, A.; Zachariadou, L.; Michos, A. Changing Epidemiology of Invasive Candidiasis in Children during a 10-Year Period. J. Fungi 2019, 5, 19.

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