Candida bloodstream infection among children hospitalized in three public sector hospitals in the Metro West region of Cape Town, South Africa

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dc.contributor.advisorEley, Brian
dc.contributor.advisorNuttall, James
dc.contributor.authorGebremicael, Mulugeta Naizgi
dc.date.accessioned2023-03-03T13:01:28Z
dc.date.available2023-03-03T13:01:28Z
dc.date.issued2022
dc.date.updated2023-02-20T12:47:16Z
dc.description.abstractIntroduction Candida bloodstream infection (BSI) causes appreciable mortality in children. There are few studies describing the epidemiology of Candida BSI in children living in the Western Cape province of South Africa. Methods A retrospective descriptive study was conducted at three public sector hospitals in Cape Town from January 2015 to December 2019. Demographic, clinical, antifungal management and patient outcome data were obtained by medical record review. Candida species and antifungal susceptibility results were extracted from the National Health Laboratory Service microbiology database Results Of the 97 Candida BSI episodes identified during the study period, 48/97 (49.5%) were C. albicans, 49/97 (50.5%) non-C. albicans species. The overall incidence risk was 0.84 Candida BSI episodes per 1000 admissions at Red Cross War Memorial Children's Hospital. Of the 77 Candida BSI episodes with available clinical information, median age (interquartile range) at the time of BSI was 6.8 (1.3-24.7) months, 46.8% were associated with moderate or severe underweight-for-age and vasopressor therapy was administered to 22 (28.6%) participants. Fluconazole resistance was documented among 25% and 0% of non-C. albicans and C. albicans isolates respectively. All Candida isolates tested were susceptible to amphotericin B and the echinocandins. The mortality rate within 30 days of BSI diagnosis was 17.3% (13/75). On multivariable analysis, concomitant bacterial infection during Candida BSI was associated with 30-day mortality, adjusted OR 5.7, 95% confidence interval: 1.4-24.0. Conclusion The study adds to the limited number of studies describing paediatric Candida BSI in sub Saharan Africa. Concomitant bacterial infection was associated with 30-day mortality.
dc.identifier.apacitationGebremicael, M. N. (2022). <i>Candida bloodstream infection among children hospitalized in three public sector hospitals in the Metro West region of Cape Town, South Africa</i>. (). ,Faculty of Health Sciences ,Department of Paediatrics and Child Health. Retrieved from http://hdl.handle.net/11427/37219en_ZA
dc.identifier.chicagocitationGebremicael, Mulugeta Naizgi. <i>"Candida bloodstream infection among children hospitalized in three public sector hospitals in the Metro West region of Cape Town, South Africa."</i> ., ,Faculty of Health Sciences ,Department of Paediatrics and Child Health, 2022. http://hdl.handle.net/11427/37219en_ZA
dc.identifier.citationGebremicael, M.N. 2022. Candida bloodstream infection among children hospitalized in three public sector hospitals in the Metro West region of Cape Town, South Africa. . ,Faculty of Health Sciences ,Department of Paediatrics and Child Health. http://hdl.handle.net/11427/37219en_ZA
dc.identifier.ris TY - Master Thesis AU - Gebremicael, Mulugeta Naizgi AB - Introduction Candida bloodstream infection (BSI) causes appreciable mortality in children. There are few studies describing the epidemiology of Candida BSI in children living in the Western Cape province of South Africa. Methods A retrospective descriptive study was conducted at three public sector hospitals in Cape Town from January 2015 to December 2019. Demographic, clinical, antifungal management and patient outcome data were obtained by medical record review. Candida species and antifungal susceptibility results were extracted from the National Health Laboratory Service microbiology database Results Of the 97 Candida BSI episodes identified during the study period, 48/97 (49.5%) were C. albicans, 49/97 (50.5%) non-C. albicans species. The overall incidence risk was 0.84 Candida BSI episodes per 1000 admissions at Red Cross War Memorial Children's Hospital. Of the 77 Candida BSI episodes with available clinical information, median age (interquartile range) at the time of BSI was 6.8 (1.3-24.7) months, 46.8% were associated with moderate or severe underweight-for-age and vasopressor therapy was administered to 22 (28.6%) participants. Fluconazole resistance was documented among 25% and 0% of non-C. albicans and C. albicans isolates respectively. All Candida isolates tested were susceptible to amphotericin B and the echinocandins. The mortality rate within 30 days of BSI diagnosis was 17.3% (13/75). On multivariable analysis, concomitant bacterial infection during Candida BSI was associated with 30-day mortality, adjusted OR 5.7, 95% confidence interval: 1.4-24.0. Conclusion The study adds to the limited number of studies describing paediatric Candida BSI in sub Saharan Africa. Concomitant bacterial infection was associated with 30-day mortality. DA - 2022_ DB - OpenUCT DP - University of Cape Town KW - Paediatric Infectious Diseases LK - https://open.uct.ac.za PY - 2022 T1 - Candida bloodstream infection among children hospitalized in three public sector hospitals in the Metro West region of Cape Town, South Africa TI - Candida bloodstream infection among children hospitalized in three public sector hospitals in the Metro West region of Cape Town, South Africa UR - http://hdl.handle.net/11427/37219 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/37219
dc.identifier.vancouvercitationGebremicael MN. Candida bloodstream infection among children hospitalized in three public sector hospitals in the Metro West region of Cape Town, South Africa. []. ,Faculty of Health Sciences ,Department of Paediatrics and Child Health, 2022 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/37219en_ZA
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Paediatrics and Child Health
dc.publisher.facultyFaculty of Health Sciences
dc.subjectPaediatric Infectious Diseases
dc.titleCandida bloodstream infection among children hospitalized in three public sector hospitals in the Metro West region of Cape Town, South Africa
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMPhil
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