Candida bloodstream infection among immunocompromised paediatric patients admitted to the University College Hospital, Ibadan, Nigeria Infection sanguine à Candida chez des patients pédiatriques immunodéprimés admis à l'Hôpital Universitaire, d'Ibadan, au Nigeria

Abstract

Background: Invasive candidiasis is a major hospital acquired fungal infection in Nigeria. Despite advances in support of critically ill patients, candidaemia is still associated with high morbidity and mortality. Data on Candida bloodstream infection among paediatric patients is limited in Nigeria and this informed this study, which was undertaken to investigate the prevalence, species distribution, antifungal susceptibility pattern for blood stream infections due to Candida species in University College Hospital, Ibadan, Nigeria.
Methodology: This was a descriptive study which recruited 322 immunocompromised paediatric patients. All Candida isolates obtained from their blood samples through blood culture were identified to species level by germ tube test and PCR-Restriction Fragment Length Polymorphism (RFLP) analysis of 16S rRNA genes with MspI. Antifungal susceptibility test was performed on the isolates using the Vitek 2 system.
Results: Eighteen (5.6%) of the 322 patients had candidaemia, with Candida albicans accounting for 14 (77.0%), and Candida glabrata and Candida tropicalis accounting for 2 (11.0%) of the isolates each. Fourteen (77.0%) isolates were susceptible to fluconazole and voriconazole, 8 (44.0%) were susceptible to caspofungin and micafungin, 10 (55.0%) were susceptible to amphotericin B and 17 (94.0%) were susceptible to flucytosine.
Conclusion: This study highlights the reality of candidaemia in hospitalized immunocompromised children, mostly caused by Candida albicans and other Candida species, exhibiting resistance to echinocandins, azoles and amphotericin B. It is important to have a high index of suspicion and efforts should be made to rightly identify the concerned Candida species and perform susceptibility testing before initiating antifungal treatment. This will ensure better outcome for the patients.