Abstract：
Candidemia is emerging as a significant concern in children, particularly among those with underlying conditions like malignancies or prematurity. The interpretation of epidemiological data on candidemias and their antifungal resistance plays a vital role in aiding diagnosis and guiding clinicians in treatment decisions. From 2014 to 2021, a retrospective analysis was conducted in İstanbul, Turkey; comparing Candida albicans and non-albicans (NAC) spp in both surviving and deceased groups. Furthermore, an examination of Candida parapsilosis and other species was performed, assessing various clinical and laboratory parameters. Among 93 patients, with a median age of 17 months, C. parapsilosis emerged as the predominant isolated species (44%), followed by C. albicans (34.4%). Resistance to fluconazole, voricanozole, and echinocandins, along with a history of broad-spectrum antibiotic use were found to be significantly higher in the non-albicans Candida group compared to C. albicans group. In the C. parapsilosis group, statistically lower age was identified in comparison to the other groups (P = .018). In addition, high fluconazole and voriconazole resistance was detected in Candida parapsilosis spp. Our study highlights a notable prevalence of C. parapsilosis, particularly in younger children, which is different from similar studies in childhood. This trend may be attributed to the common use of total parenteral nutrition and central venous catheter in gastrointestinal disorders and metabolic diseases. Furthermore, as anticipated, high azole resistance is noted in C. parapsilosis and other non-albicans Candida species. Interestingly, resistance to both amphotericin B and echinocandins within this group has been notably high. It is crucial to emphasize the considerable antifungal resistance seen in C. parapsilosis isolates.
摘要：
念珠菌菌血症正在成为儿童的一个重要问题，特别是那些患有恶性肿瘤或早产等潜在疾病的人。对念珠菌及其抗真菌耐药性的流行病学数据的解释在帮助诊断和指导临床医生做出治疗决定方面起着至关重要的作用。从2014年到2021年，在伊斯坦布尔进行了回顾性分析，土耳其；比较幸存和死亡组中的白色念珠菌和非白色念珠菌（NAC）。此外，进行了近平滑念珠菌和其他物种的检查，评估各种临床和实验室参数。在93名患者中，平均年龄为17个月，梭菌是主要的孤立物种(44%)，其次是白色念珠菌(34.4%)。对氟康唑的耐药性，voricanozole,和棘白菌素,与白色念珠菌组相比,非白色念珠菌组的广谱抗生素使用史显著高于白色念珠菌组.在近平滑梭菌组，与其他组相比,年龄在统计学上较低(P=0.018).此外,对氟康唑和伏立康唑有较高的耐药性。我们的研究强调了近融合梭菌的显著患病率，尤其是年幼的孩子，这与童年时期的类似研究不同。这种趋势可能归因于在胃肠道疾病和代谢疾病中普遍使用全胃肠外营养和中心静脉导管。此外，正如预期的那样，在近平滑梭菌和其他非白色念珠菌物种中注意到高的唑类抗性。有趣的是,该组中对两性霉素B和棘白菌素的耐药性一直很高。重要的是要强调在近拉丝梭菌分离株中看到的相当大的抗真菌抗性。
