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Active surveillance of candidemia in children from latin america: A key requirement for improving disease outcome

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dc.contributor.author Santolaya, María E.
dc.contributor.author Alvarado, Tito
dc.contributor.author Queiroz-Telles, Flavio
dc.contributor.author Colombo, Arnaldo L.
dc.contributor.author Zurita, Jeanette
dc.contributor.author Tiraboschi, Iris N.
dc.contributor.author Cortes, Jorge Alberto
dc.contributor.author Thompson, Luis
dc.contributor.author Guzman, Manuel
dc.contributor.author Sifuentes, José
dc.contributor.author Echevarria Zarate, Juan Ignacio
dc.contributor.author Nucci, Marcio
dc.date.accessioned 2022-01-04T20:31:46Z
dc.date.available 2022-01-04T20:31:46Z
dc.date.issued 2014
dc.identifier.uri https://hdl.handle.net/20.500.12866/10637
dc.description.abstract Background: 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_US
dc.language.iso eng
dc.publisher Wolters Kluwer Health
dc.relation.ispartofseries Pediatric Infectious Disease Journal
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Latin America en_US
dc.subject human en_US
dc.subject major clinical study en_US
dc.subject controlled study en_US
dc.subject infant en_US
dc.subject priority journal en_US
dc.subject Risk Factors en_US
dc.subject epidemiology en_US
dc.subject Multivariate Analysis en_US
dc.subject school child en_US
dc.subject artificial ventilation en_US
dc.subject Hospitalization en_US
dc.subject incidence en_US
dc.subject prematurity en_US
dc.subject Prospective Studies en_US
dc.subject prospective study en_US
dc.subject South and Central America en_US
dc.subject hospital en_US
dc.subject article en_US
dc.subject infection risk en_US
dc.subject Infant, Newborn en_US
dc.subject newborn en_US
dc.subject mortality en_US
dc.subject amphotericin B deoxycholate en_US
dc.subject Candida en_US
dc.subject Candida albicans en_US
dc.subject Candida parapsilosis en_US
dc.subject Candida tropicalis en_US
dc.subject candidemia en_US
dc.subject corticosteroid en_US
dc.subject intensive care unit en_US
dc.subject survival en_US
dc.subject Antifungal Agents en_US
dc.subject kidney disease en_US
dc.subject Candidemia en_US
dc.subject children en_US
dc.subject Intensive Care Units en_US
dc.subject neurologic disease en_US
dc.subject neutropenia en_US
dc.subject parenteral nutrition en_US
dc.subject respiratory tract disease en_US
dc.subject survival rate en_US
dc.title Active surveillance of candidemia in children from latin america: A key requirement for improving disease outcome en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1097/INF.0000000000000039
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.03
dc.relation.issn 1532-0987


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