Epidemiology and fungal infection risk factors in patients hospitalized in neonatal and paediatric intensive care units – a multicentre pilot study

Invasive fungal infections are associated with very high mortality and morbidity. Candida sp. is a leading etiological cause of invasive fungal infections (IFI). The aim of this study was to investigate the epidemiology of FI in patients admitted to neonatal and paediatric ICU (NICU and PICU) to investigate risk factors that may contribute to FI development. In this retrospective epidemiologic multicentre pilot study five neonatal and five paediatric intensive care units were included. The data about epidemiology, patient significant clinical data, chronic metabolic disease, surgery, mechanical ventilation, dialysis, central venous catheter, urinary catheter, arterial catheter, total parenteral nutrition, leucopenia, neutropenia, previous antimicrobial therapy or prophylaxis were collected. In this study 25 NICU and 40 PICU patients treated with antifungal drugs during 2014 were enrolled. Among patients with fungal infection from the NICU the most often diagnosis and reason for NICU hospitalization was prematurity. In four NICUs C. albicans was the most common clinically significant fungal isolate. In one NICU C. parapsilosis was the most frequently isolated yeast. From the urine of one NICU patient with urogenital disease C. krusei was isolated. In four of five PICUs C. albicans was the most common cause of fungal infections. C. glabrata and C. krusei were also recorded in PICUs. In one PICU patients with clinically important moulds were recorded – patients with haematological malignancy (Fusarium sp.) and solid organ transplantation (Aspergillus spp). Thus, surveillance of epidemiology, fungal susceptibility and risk factors associated with fungal infection in a prospective multicentre study could be of great value in the future.