{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T01:34:03Z","timestamp":1790213643589,"version":"4.1.0"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,8]]},"abstract":"\n Background:<\/jats:title>\n We aimed to describe the epidemiology of candidemia among children in South Africa.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n We conducted laboratory-based surveillance among neonates (\u226428 days), infants (29 days to <1 year), children (1\u201311 years) and adolescents (12\u201317 years) with\n Candida<\/jats:italic>\n species cultured from blood during 2012\u20132017. Identification and antifungal susceptibility of viable isolates were performed at a reference laboratory. We used multivariable logistic regression to determine the association between\n Candida parapsilosis<\/jats:italic>\n candidemia and 30-day mortality among neonates.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Of 2996 cases, neonates accounted for 49% (n = 1478), infants for 27% (n = 806), children for 20% (n = 589) and adolescents for 4% (n = 123). The incidence risk at tertiary public sector hospitals was 5.3 cases per 1000 pediatric admissions (range 0.39\u2013119.1). Among 2943 cases with single-species infections,\n C. parapsilosis<\/jats:italic>\n (42%) and\n Candida albicans<\/jats:italic>\n (36%) were most common.\n Candida auris<\/jats:italic>\n was among the 5 common species with an overall prevalence of 3% (n = 47). Fluconazole resistance was more common among\n C. parapsilosis<\/jats:italic>\n (55% [724\/1324]) versus other species (19% [334\/1737]) (\n P<\/jats:italic>\n < 0.001). Of those with known treatment (n = 1666), 35% received amphotericin B deoxycholate alone, 32% fluconazole alone and 30% amphotericin B deoxycholate with fluconazole. The overall 30-day in-hospital mortality was 38% (n = 586) and was highest among neonates (43% [323\/752]) and adolescents (43% [28\/65]). Compared with infection with other species,\n C. parapsilosis<\/jats:italic>\n infection was associated with a reduced mortality among neonates (adjusted odds ratio 0.41, 95% confidence interval: 0.22\u20130.75,\n P<\/jats:italic>\n = 0.004).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n \n Candidemia in this setting mainly affected neonates and infants and was characterized by fluconazole-resistant\n C. parapsilosis<\/jats:italic>\n with no increased risk of death.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/inf.0000000000003151","type":"journal-article","created":{"date-parts":[[2021,4,20]],"date-time":"2021-04-20T01:13:04Z","timestamp":1618881184000},"page":"730-737","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":38,"title":["Epidemiology of Culture-confirmed Candidemia Among Hospitalized Children in South Africa, 2012\u20132017"],"prefix":"10.1097","volume":"40","author":[{"given":"Liliwe","family":"Shuping","sequence":"first","affiliation":[{"name":"Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Mpembe","sequence":"additional","affiliation":[{"name":"Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mabatho","family":"Mhlanga","sequence":"additional","affiliation":[{"name":"Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa"},{"name":"School of Molecular and Cell Biology, Faculty of Science, University of the Witwatersrand, Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serisha D.","family":"Naicker","sequence":"additional","affiliation":[{"name":"Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa"},{"name":"Department of Clinical Microbiology and Infectious Diseases, School of Pathology, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsidiso G.","family":"Maphanga","sequence":"additional","affiliation":[{"name":"Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa"},{"name":"Department of Clinical Microbiology and Infectious Diseases, School of Pathology, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernest","family":"Tsotetsi","sequence":"additional","affiliation":[{"name":"Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service, Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeannette","family":"Wadula","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology and Infectious Diseases, School of Pathology, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa"},{"name":"Department of Microbiology, National Health Laboratory Service, Chris Hani Baragwanath Hospital, Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sithembiso","family":"Velaphi","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health, Chris Hani Baragwanath Hospital, Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Firdose","family":"Nakwa","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health, Chris Hani Baragwanath Hospital, Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vindana","family":"Chibabhai","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology and Infectious Diseases, School of Pathology, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa"},{"name":"Department of Microbiology, National Health Laboratory Service, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prasha","family":"Mahabeer","sequence":"additional","affiliation":[{"name":"Department of Microbiology, National Health Laboratory Service, King Edward VIII Hospital, KZN Academic Complex, Durban, South Africa"},{"name":"Department of Medical Microbiology, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masego","family":"Moncho","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Faculty of Health Sciences, Universitas Hospital, National Health Laboratory Service, University of Free State, Bloemfontein, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Prentice","sequence":"additional","affiliation":[{"name":"Division of Medical Microbiology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa"},{"name":"Groote Schuur Microbiology Laboratory, National Health Laboratory Service, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen","family":"Bamford","sequence":"additional","affiliation":[{"name":"Division of Medical Microbiology and Immunology, Department of Pathology, Faculty of Health Sciences, Stellenbosch University\/National Health Laboratory Services, Tygerberg, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kessendri","family":"Reddy","sequence":"additional","affiliation":[{"name":"Division of Medical Microbiology and Immunology, Department of Pathology, Faculty of Health Sciences, Stellenbosch University\/National Health Laboratory Services, Tygerberg, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Maluleka","sequence":"additional","affiliation":[{"name":"Department of Microbiology, National health Laboratory Service, Dr George Mukhari Hospital, Johannesburg, South Africa"},{"name":"Department of Paediatrics and Child Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dini","family":"Mawela","sequence":"additional","affiliation":[{"name":"Department of Microbiology, National health Laboratory Service, Dr George Mukhari Hospital, Johannesburg, South Africa"},{"name":"Department of Paediatrics and Child Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motshabi","family":"Modise","sequence":"additional","affiliation":[{"name":"Division of Public Health Surveillance and Response, National Institute for Communicable 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