627. Decline in Neonatal and Pediatric Candidemia Preliminary Results From Population-Based Active Surveillance 2008-2010
Session: Abstracts: Mycology
Friday, October 22, 2010
Background:

Pediatric patients, particularly neonates, have historically had the highest candidemia incidence rates, with considerable morbidity and mortality.  However, few recent representative epidemiological data exist. To describe the changing epidemiology of candidemia among the pediatric population, we analyzed data from an ongoing, population-based surveillance conducted during 2008 - 2010.

Methods:

Incident cases of candidemia were identified through active, population-based surveillance in the metropolitan Atlanta (ATL) area (8 counties) and in Baltimore (BTM) City and County. Demographic and clinical data were collected for all case-patients, defined as residents of the catchment area with a new positive blood culture growing Candida spp. We calculated crude age-specific incidence rates using 2008 state census population denominators, and compared them to previous population-based surveillance in ATL (1992-3), and BTM (1998-2000).  Candida species were confirmed at CDC.

Results:

During the first year of surveillance, we detected 42 pediatric (age 0-19 years) cases in ATL and 17 in BTM.  Overall crude pediatric incidence rates per 100,000 population were 3.8 in ATL (51% decline), and 4.5 in BTM (53% decline).  Neonate (age 0-1 month) incidence was 220/ 100,000 (70% decline) in ATL, and 249/100,000 (48% decline) in BTM.  Seventy-seven percent of neonate case-patients were male and 68% were black; 50% were extremely low birth weight (<1000g). Among all pediatric case-patients, 80% had a central venous catheter and 77% received total parenteral nutrition.  Twenty seven percent of neonatal and 22% of non-neonatal case-patients died.  C. albicans was the most common species (69%), followed by C. parapsilosis (23%).

Conclusion:

We demonstrate a decrease in incidence of both neonatal and non-neonatal pediatric candidemia. Further study to determine factors associated with this decline is warranted.


Subject Category: M. Mycology including clinical and basic studies of fungal infections

Speakers:
Monika Roy, MD , Centers for Disease Control and Prevention, Atlanta, GA
Angela Ahlquist, MPH , Centers for Disease Control and Prevention, Atlanta, GA
Monica Farley, MD , Emerging Infections Program, Atlanta VA Medical Center, Decatur, GA
Lee Harrison, MD , University of Pittsburgh Graduate School, Pittsburgh, PA
Wendy Baughman, MSPH , Georgia Department of Community Health, Atlanta, GA
Betsy Siegel, RN, BSN , Emerging Infections Program, Atlanta VA Medical Center, Decatur, GA
Rosemary Hollick, MD , Johns Hopkins University, Baltimore, MD
Shawn Lockhart, PhD , Centers for Disease Control and Prevention, Atlanta, GA
Tom Chiller, MD, MSTMH , Centers for Disease Control and Prevention, Atlanta, GA
Benjamin J. Park, MD , Centers for Disease Control and Prevention, Atlanta, GA

Disclosures:

M. Roy, None

A. Ahlquist, None

M. Farley, None

L. Harrison, None

W. Baughman, None

B. Siegel, None

R. Hollick, None

S. Lockhart, None

T. Chiller, None

B. J. Park, None

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