Journal de mycologie medicale · 2026
Candida (Candidozyma) auris in pediatric population: risk factors, clinical presentation, and outcomes.
СтатьяСистематический обзорОбзорНазвание и аннотация: Перевод в очереди
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Nascimento Bianca Canupa Mancuzo, de Barros Fernanda Júlia, de Souza Gleyce Hellen de Almeida, Lima Ana Caroline Pinto, Martins Natália Daiane Garoni, Carlesse Fabianne, Bastos Rafael Wesley, Rossato Luana
Аннотация
INTRODUCTION: Candida (Candidozyma) auris, identified as a human pathogen in 2009, has emerged as a significant nosocomial fungus due to its multidrug resistance and diagnostic challenges. It is associated with invasive infections, particularly in critically ill patients exposed to broad-spectrum antibiotics and invasive procedures. Pediatric patients in intensive care units are at increased risk owing to the use of mechanical ventilation, parenteral nutrition, central venous catheters, and antimicrobial agents.
MATERIALS AND METHODS: A systematic review of the literature was conducted in the PubMed, Embase, and Scopus databases between January 2011 to January 2025.
RESULTS: Sixteen studies met the inclusion criteria, totaling 110 pediatric cases of C. auris infection. Most cases were reported in Colombia (45.5 %), followed by the United States (18.1 %) and Venezuela (15.4 %). Coinfections were identified in 10.9 % of cases, mainly involving Enterobacter spp., Klebsiella spp., and Staphylococcus spp. Bloodstream infection was the main clinical presentation (93.6 %), and the median time to isolation of C. auris was 20.3 days. The most commonly used antifungals in isolated cases were voriconazole (38.9 %), amphotericin B (35.2 %), and caspofungin (33.3 %). Mortality was 39.1 %, while 52.7 % survived. Multiple antifungal combinations have been reported, with amphotericin B and micafungin being the most common. Among 33 clinical isolates, high resistance to fluconazole (60.6%) and variable susceptibility to amphotericin B were observed. Echinocandins, such as micafungin and anidulafungin, showed greater efficacy, although resistance to caspofungin has been reported.
CONCLUSION: C. auris in pediatric patients represents a growing challenge, especially in preterm neonates, due to high antifungal resistance and diagnostic difficulties.
MATERIALS AND METHODS: A systematic review of the literature was conducted in the PubMed, Embase, and Scopus databases between January 2011 to January 2025.
RESULTS: Sixteen studies met the inclusion criteria, totaling 110 pediatric cases of C. auris infection. Most cases were reported in Colombia (45.5 %), followed by the United States (18.1 %) and Venezuela (15.4 %). Coinfections were identified in 10.9 % of cases, mainly involving Enterobacter spp., Klebsiella spp., and Staphylococcus spp. Bloodstream infection was the main clinical presentation (93.6 %), and the median time to isolation of C. auris was 20.3 days. The most commonly used antifungals in isolated cases were voriconazole (38.9 %), amphotericin B (35.2 %), and caspofungin (33.3 %). Mortality was 39.1 %, while 52.7 % survived. Multiple antifungal combinations have been reported, with amphotericin B and micafungin being the most common. Among 33 clinical isolates, high resistance to fluconazole (60.6%) and variable susceptibility to amphotericin B were observed. Echinocandins, such as micafungin and anidulafungin, showed greater efficacy, although resistance to caspofungin has been reported.
CONCLUSION: C. auris in pediatric patients represents a growing challenge, especially in preterm neonates, due to high antifungal resistance and diagnostic difficulties.