Comparative Analysis of Candida Species and Mortality in Pediatric and Adult Intensive Care Unit Patients Pediyatrik ve Yetişkin Yoğun Bakım Hastalarında Kandida Türleri ve Mortalite: Karşılaştırmalı Bir Analiz
Cocuk Enfeksiyon Dergisi, vol.20, no.2, pp.145-153, 2026 (ESCI, Scopus, TRDizin)
- Publication Type: Article / Article
- Volume: 20 Issue: 2
- Publication Date: 2026
- Doi Number: 10.5578/ced.20260218
- Journal Name: Cocuk Enfeksiyon Dergisi
- Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus, Central & Eastern European Academic Source (CEEAS), CINAHL, EMBASE, TR DİZİN (ULAKBİM), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Page Numbers: pp.145-153
- Keywords: adult, Candida, intensive care unit, mortality, pediatric
- Ankara Yıldırım Beyazıt University Affiliated: No
Abstract
Objective: This study aimed to retrospectively investigate the risk factors affecting mortality in pediatric and adult patients with candidemia followed in the pediatric and adult intensive care units of Ankara Bilkent City Hospital. Material and Methods: The medical records of 101 pediatric (1 month-18 years) and 75 adult (≥18 years) patients diagnosed with candidemia between 2018 and 2023 were reviewed. Demographic data, Candida species distribution, antifungal treatment strategies, and mortality outcomes were evaluated. Results: In our study, the number of pediatric patients was 101 (57.4%), while the number of adult patients was 75 (42.6%). In both pediatric and adult groups, non-albicans Candida species were the most frequently isolated pathogens, with rates of 56.4% and 54.7%, respectively. The seven-day and 30-day mortality rates were significantly higher in adult patients compared with pediatric patients (seven-day mortality: 37% vs. 8.9%; 30-day mortality: 14% vs. 7.6%; p< 0.001). In univariate analysis, catheter retention, mechanical ventilation, thrombocytopenia, and corticosteroid use were associated with seven-day mortality in both groups. In the adult group, the absence of antifungal therapy was additionally identified as an independent risk factor. In multivariate analysis, mechanical ventilation and thrombocytopenia were independently associated with seven-day mortality among the pediatric patients, while corticosteroid use was significantly associated with 30-day mortality. Failure to remove the catheter increased the risk of mortality by 48.6-fold in children (p< 0.001) and by 5.2-fold in adults (p= 0.015). Intubation increased mortality risk by 13.1-fold in pediatric patients (p= 0.004) and by 3.3-fold in adults (p= 0.022). The absence of antifungal therapy increased the mortality risk by 43.5-fold in adults (p< 0.001). Conclusion: Mortality rates were significantly higher in adult patients compared to pediatric patients. In both age groups, mechanical ventilation and steroid use emerged as major risk factors for increased mortality. These findings suggest that early initiation of empirical antifungal therapy, especially in high-risk patients, may help reduce mortality. Furthermore, timely catheter removal and closer monitoring of the patients requiring mechanical ventilation or steroid therapy may contribute to improved outcomes by reducing adverse consequences of candidemia.