Candiduria in Critically Ill Children

We studied 28 cases of pediatric candiduria for risk factors and predictors for mortality among 101 children admitted within a 2-year period to two pediatric intensive care units in a tertiary hospital. The case-control study, comparing candidemic and noncandiduric children matched for underlying disease, age, APACHE II score, and surgical intervention, revealed several risk factors for candiduria. Urinary tract abnormalities, use of a urinary catheter, prior dialysis, total parenteral nutrition, use of a vascular catheter, artificial ventilation, and duration of therapy with broad-spectrum antibiotics were statistically significantly associated with candiduria (P < .001 -.04). Univariate analysis comparing risk factors between survivors and nonsurvivors showed that congenital malformations, organ failure, surgery within 1 week, ventilatory support for >21 days, use of more than four antibiotics in therapy for 5:10 days, and absence of antifungal therapy were significant predictors of poor outcome (P <.001-.04).