Table 1.
Factors associated with 30-day mortality in invasive candidiasis episodes.
| Total Episodes (n, %) |
Episodes with 30 Days Survival (n, %) | Episodes with 30 Days Mortality (n, %) | p Value | |
|---|---|---|---|---|
| Total patients (n) | 127 | 102 (80.3) | 25 (19.7) | |
| Female: Male | 1.04 | 1.04 | 1.08 | 0.92 |
| Age at first episode in years (median, IQR) | 2.45 (0.36, 5.65) | 2.5 (0.4, 5.3) | 1.2 (0.05, 6.3) | 0.28 |
| Underlying diseases | ||||
| Immune-compromised patients | 66 (51.9) | 53 (52) | 13 (52) | 0.99 |
| Allogeneic HCT | 21 (16.5) | 16 (15.7) | 5 (20) | |
| Autologous HCT | 6 (4.7) | 5 (4.9) | 1 (4) | |
| Hematological malignancy | 16 (12.6) | 15 (14.7) | 1 (4) | |
| Solid tumors | 14 (11) | 13 (12.7) | 1 (4) | |
| Others | 9 (7.1) | 4 (3.9) | 5 (20) | |
| Prematurity | 22 (17.3) | 16 (15.7) | 6 (24) | 0.37 |
| Other underlying disease | 65 (51.2) | 56 (54.9) | 9 (36) | 0.09 |
| Abdominal surgery | 18 (14.2) | 11 (10.8) | 7 (28) | 0.049 |
| Central venous catheter | 104 (81.9) | 82 (80.4) | 22 (88) | 0.56 |
| Total parenteral nutrition | 71 (55.9) | 52 (51) | 19 (76) | 0.024 |
| Number of hospitalization days in the last 3 months, median (IQR) (n = 124) | 26.5 (10, 51) | 27 (10, 50) | 25 (8, 69.5) | 0.92 |
| Candidemia developed while in PICU | 53 (41.7) | 33 (32.4) | 20 (80) | <0.001 |
| Time from hospital admission to candidemia (first positive culture), days, median (IQR) | 12 (5, 28) | 11 (2, 26.5) | 20 (8, 57.5) | 0.017 |
| Previous antifungal therapy | 26 (20.5) | 16 (15.7) | 10 (40) | 0.007 |
| Azole | 25 (19.7) | 15 (14.7) | 10 (40) | 0.009 |
| Amphotericin B | 1 (0.8%) | 1 (1) | 0 (0) | 1 |
| Echinocandin | 4 (3.1%) | 3 (2.9) | 1 (4) | 1 |
| Systemic antibiotics within a month preceding candidemia onset | 114 (89.8) | 90 (88.2) | 24 (96) | 0.46 |
| Beta-lactam | 105 (82.7) | 83 (81.4) | 22 (88) | 0.53 |
| Penicillins | 59 (46.5) | 46 (45.1) | 13 (52) | 0.53 |
| Cephalosporins | 45 (35.4) | 40 (39.2) | 5 (20) | 0.072 |
| Carbapenem | 67 (52.8) | 47 (46.1) | 20 (80) | 0.002 |
| Aminoglycosides | 38 (29.9) | 28 (27.5) | 10 (40) | 0.22 |
| Vancomycin | 51 (40.2) | 36 (35.3) | 15 (60) | 0.024 |
| Colistin | 7 (5.5) | 5 (4.9) | 2 (8) | 0.6 |
| Fluoroquinolones | 21 (16.5) | 17 (16.7) | 4 (16) | 1 |
| Absolute neutrophil count 109/L median (IQR) | 4.5 (0.66, 10.5) | 4.45 (0.5, 9.8) | 6 (0.96, 15.7) | 0.36 |
| Severe neutropenia at the time of candidemia | 30 (23.6) | 25 (24.5) | 5 (20) | 0.63 |
| Microbiological data | ||||
| Candida non-albicans | 71 (55.9) | 58 (56.8) | 13 (52) | 0.66 |
| Poly-candidemia | 4 (3.1) | 3 (2.9) | 1 (4) | 1 |
| Shock | 27 (21.3) | 13 (12.7) | 14 (56) | 0 |
| Chronic disseminated candidiasis | 15 (11.8) | 14 (13.7) | 1 (4) | 0.3 |
| CVC removal | 46/104 (36.8) | 39/82 (47.5) | 7/22 (31.8) | 0.15 |
| Fluconazole resistance | 10/121 (8.2) | 8/98 (8.1) | 2/23 (8.6) | 1 |
| Inappropriate empirical antifungal treatment | 9 (7.1) | 6 (5.9) | 3 (12) | 0.38 |
| Duration of candidemia (days), median (IQR) | 1 (0, 5) | 0 (0, 4) | 3 (0.5, 7.5) | 0.05 |
HCT: hematopoietic stem cell transplantation, PICU: pediatric intensive care unit, CVC: central venous catheter.