Evidence map›Paper›PMID 36737689›Full record

ArticleBMC infectious diseases2023

Candida bloodstream infection among children hospitalised in three public-sector hospitals in the Metro West region of Cape Town, South Africa.

Mulugeta Naizgi Gebremicael, James J C Nuttall, Hafsah D Tootla, Amanda Khumalo, Lloyd Tooke, Shamiel Salie, Rudzani Muloiwa, Natasha Rhoda, Wisdom Basera, Brian S Eley

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC infectious diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.6field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Observational
  3. Changing Climate, ChangingJournal of fungi (Basel, Switzerland) · 2025
    Review
  4. Neonatal Invasive Candidiasis: Current Concepts.Indian journal of pediatrics · 2025
    Review
  5. Article
  6. Unveiling novel insights: geraniol's enhanced anti-candida efficacy and mechanistic innovations against multidrug-resistant candida strains.Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] · 2024
    Article
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 2 countries.

Mulugeta Naizgi GebremicaelPaediatric Infectious Diseases Unit, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa. naizgimulugeta@gmail.com.
James J C NuttallPaediatric Infectious Diseases Unit, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
Hafsah D TootlaDivision of Medical Microbiology, National Health Laboratory Service, Red Cross War Memorial Children's Hospital and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
Amanda KhumaloDivision of Medical Microbiology, National Health Laboratory Service, Red Cross War Memorial Children's Hospital and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
Lloyd TookeDivision of Neonatal Medicine, Department of Paediatrics and Child Health, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
Shamiel SaliePaediatric Critical Care Unit, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
Rudzani MuloiwaDepartment of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa.
Natasha RhodaDivision of Neonatal Medicine, Department of Paediatrics and Child Health, Mowbray Maternity Hospital, University of Cape Town, Cape Town, South Africa.
Wisdom BaseraSchool of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
Brian S EleyPaediatric Infectious Diseases Unit, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
University of Cape Town · ZANational Health Laboratory Service · ZASouth African Medical Research Council · ZA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCandida bloodstream infection (BSI) causes appreciable mortality in neonates and children. There are few studies describing the epidemiology of Candida BSI in children living in sub-Saharan Africa.

methodsA retrospective descriptive study was conducted at three public sector hospitals in Cape Town, South Africa. Demographic and clinical details, antifungal management and patient outcome data were obtained by medical record review. Candida species distribution and antifungal susceptibility testing results were obtained from the National Health Laboratory Service database.

resultsOf the 97 Candida BSI episodes identified during a five-year period, 48/97 (49%) were Candida albicans (C. albicans), and 49/97 (51%) were non-C. albicans species. The overall incidence risk was 0.8 Candida BSI episodes per 1000 admissions at Red Cross War Memorial Children's Hospital. Of the 77/97 (79%) Candida BSI episodes with available clinical information, the median age (interquartile range) at the time of BSI was 7 (1-25) months, 36/77 (47%) were associated with moderate or severe underweight-for-age and vasopressor therapy was administered to 22/77 (29%) study participants. Most of the Candida BSI episodes were healthcare-associated infections, 63/77 (82%). Fluconazole resistance was documented among 17%, 0% and 0% of C. parapsilosis, C. tropicalis and C. albicans isolates, respectively. All Candida isolates tested were susceptible to amphotericin B and the echinocandins. The mortality rate within 30 days of Candida BSI diagnosis was 13/75 (17%). On multivariable analysis, factors associated with mortality within 30 days of Candida BSI diagnosis included vasopressor therapy requirement during Candida BSI, adjusted Odds ratio (aOR) 53 (95% confidence interval 2-1029); hepatic dysfunction, aOR 13 (95% CI 1-146); and concomitant bacterial BSI, aOR 10 (95% CI 2-60).

conclusionThe study adds to the limited number of studies describing paediatric Candida BSI in sub-Saharan Africa. Non-C. Albicans BSI episodes occurred more frequently than C. albicans episodes, and vasopressor therapy requirement, hepatic dysfunction and concomitant bacterial BSI were associated with an increase in 30-day mortality.

Indexed as

CandidemiaCandidiasisSepsisAntifungal AgentsCandidaCandida albicansCandida parapsilosisCandida tropicalisChildDrug Resistance, FungalHospitals, PublicHumansInfantInfant, NewbornMicrobial Sensitivity TestsPublic SectorAntifungal AgentsAntifungal susceptibilityCandida bloodstream infectionCandidaemiaCandida speciesChildrenMortality

Identifiers

PMID36737689
PMCPMC9896677
OpenAlexW4319081945

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.