C. parapsilosis exhibited no difference in mortality risk with other Candida species

Dotis J. Pediatr Infect Dis J. 2012;doi:10.1097/INF.0b013e31824da7fe.

Candida parapsilosis is the second most frequent cause of candidemia, and although more closely associated with mechanical ventilation than other Candida species, mortality did not significantly differ between those with and without C. parapsilosis candidemia, according to study results recently published online.

To determine risk factors associated with C. parapsilosis bloodstream infections compared with those resulting from other Candida species, researchers conducted a retrospective analysis of demographic data, clinical features, therapeutic procedures and outcomes associated with Candida bloodstream infections that occurred at The Children’s Hospital of Philadelphia (CHOP) from 1997 to 2009.

During the study period, 406 children experienced bloodstream infections due to Candida species at CHOP, including 198 episodes caused by C. albicans, 99 by C. parapsilosis and 109 by other non-albicans and non-parapsilosis Candida species: non-albicans Candida episodes totaled 136, equivalent to that of C. albicans.

C. parapsilosis bloodstream infections were more common than non-parapsilosis Candida species for those aged 2 years or younger vs. older patients (62% vs. 50%; OR=1.24; 95% CI, 1.03-1.51). Patients with C. parapsilosis were also found to be more likely to undergo mechanical ventilation within 48 hours of bloodstream infections (OR=1.38; 95% CI, 1.01-1.85).

In addition, no significant differences were observed between patients with candidemia due to C. parapsilosis and those with candidemia due to all other Candida species, including the presence of central intravascular catheters, comorbidities and clinical or surgical procedures, previous administration of immunosuppressive or antifungal agents and mortality (12% vs. 14%, P=.738).

“C. parapsilosis fungemia has been associated with gastrointestinal colonization and transmission from the hands of health care workers contributing to its higher frequency in young patients found in our study,” the researchers said. “Colonization of the gastrointestinal tract with C. parapsilosis occurs at a higher rate in neonates, further increasing their risk of C. parapsilosis fungemia. Transmission of C. parapsilosis from the hands of health care workers as a source to neonates and children has been suggested as a contributing factor, because the organism is commonly carried on the hands of health care personnel or other healthy hosts.”

Disclosure: The researchers report funding support from the NIH.

Follow the PediatricSuperSite.com on Twitter.