RT Journal Article
T1 Epidemiology and antifungal susceptibility of bloodstream fungal isolates in pediatric patients: a Spanish multicenter prospective survey.
A1 Pemán, Javier
A1 Cantón, Emilia
A1 Linares-Sicilia, María José
A1 Roselló, Eva María
A1 Borrell, Nuria
A1 Ruiz-Pérez-de-Pipaon, María Teresa
A1 Guinea, Jesús
A1 García, Julio
A1 Porras, Aurelio
A1 García-Tapia, Ana María
A1 Pérez-Del-Molino, Luisa
A1 Suárez, Anabel
A1 Alcoba, Julia
A1 García-García, Inmaculada
K1 Antifúngicos
K1 Farmacorresistencia fúngica
K1 Hongos
K1 Pruebas de sensibilidad microbiana
K1 Prevalencia
K1 Estudios prospectivos
K1 España
K1 Niño
AB Data on fungemia epidemiology and antifungal susceptibility of isolates from children are scarce, leading frequently to pediatric empirical treatment based on available adult data. The present study was designed to update the epidemiological, mycological, and in vitro susceptibility data on fungal isolates from children with fungemia in Spain. All fungemia episodes were identified prospectively by blood culture over 13 months at 30 hospitals. Tests of susceptibility to amphotericin B, flucytosine, fluconazole, itraconazole, posaconazole, voriconazole, anidulafungin, caspofungin, and micafungin were performed at participant institutions by a microdilution colorimetric method. New species-specific clinical breakpoints for fluconazole, voriconazole, and echinocandins were also applied. A total of 203 episodes of fungemia in 200 children were identified. A higher proportion of fungal isolates was from general wards than intensive care units (ICU). Candida parapsilosis (46.8%), Candida albicans (36.5%), Candida tropicalis (5.9%), Candida glabrata (3.9%), and Candida guilliermondii (2.5%) were the leading species. C. parapsilosis was the predominant species except in neonates. C. albicans was the most frequent in neonatal ICU settings (51.9%). Intravascular catheter (79.3%), surgery (35%), prematurity (30%), and neutropenia (11%) were the most frequent predisposing factors. Most Candida isolates (95.1%) were susceptible to all antifungals. When the new species-specific clinical breakpoints were applied, all C. parapsilosis isolates were susceptible to echinocandins except one, which was micafungin resistant. This is the largest published series of fungemia episodes in the pediatric setting. C. parapsilosis is the most prevalent species in Spain, followed by C. albicans and C. tropicalis. Resistance to azole and echinocandin agents is extremely rare among Candida species. The fluconazole resistance rate in Spain has decreased in the last 10 years.
PB American Society for Microbiology
SN 0095-1137
YR 2011
FD 2011-12
LK http://hdl.handle.net/10668/1588
UL http://hdl.handle.net/10668/1588
LA en
NO Pemán J, Cantón E, Linares-Sicilia MJ, Roselló EM, Borrell N, Ruiz-Pérez-de-Pipaon MT, et al. Epidemiology and antifungal susceptibility of bloodstream fungal isolates in pediatric patients: a Spanish multicenter prospective survey. J Clin Microbiol. 2011; 49(12):4158-63
NO Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't;
DS RISalud
RD Apr 10, 2025