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The Epidemiology of Neonatal and Pediatric Candidemia in England and Wales, 2000–2009

Oeser, Clarissa MRCPCH*; Lamagni, Theresa PhD; Heath, Paul T. FRCPCH*; Sharland, Mike FRCPCH*; Ladhani, Shamez MRCPCH, PhD*†

The Pediatric Infectious Disease Journal: January 2013 - Volume 32 - Issue 1 - p 23–26
doi: 10.1097/INF.0b013e318275612e
Original Studies

Background: There are few population-based studies on the epidemiology of neonatal and pediatric invasive Candida infections, despite their significant clinical impact on patients. This study aimed to describe the epidemiology of pediatric candidemia in England and Wales during a 10-year period as a means of quantifying the changing burden of infection and identifying emerging trends.

Methods: National Health Service hospital microbiology laboratories in England and Wales routinely report clinically significant invasive infections electronically to the Health Protection Agency. Records of all positive blood cultures for Candida species in children aged <15 years between 2000 and 2009 inclusive were extracted for analysis.

Results: During 2000 to 2009, 1473 childhood candidemia cases were reported in England and Wales (annual incidence, 1.52/100,000 person-years), with the highest rate in <1 year olds (n = 706; 11.0/100,000), followed by 1–4 year olds (n = 440; 1.77/100,000), 5–9 year olds (n = 168; 0.53/100,000) and 10–14 year olds (n = 159; 0.47/100,000). Incidence increased from 1.04 per 100,000 in 2000 to 2.09 per 100,000 in 2007 (P < 0.001) before falling to 1.53 per 100,000 in 2009 (P < 0.001). Candida species was reported in 89.6% (1320/1473) cases, with Candida albicans and Candida parapsilosis accounting for most infections in all age groups. There were no significant differences in species distribution by season or year of study and the proportion of non-albicans cases did not increase with time.

Conclusions: Pediatric candidemia rates are beginning to fall in England and Wales. C. albicans continues to account for most Candida bloodstream infections in all age groups with no evidence of increases in non-albicans species.

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From the *Paediatric Infectious Diseases Research Group, Division of Clinical Sciences, St. George’s, University of London; and Health Protection Services Colindale, London, United Kingdom.

Accepted for publication August 21, 2012.

The authors have no funding or conflicts of interest to disclose.

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Address for correspondence: Shamez Ladhani, MRCPCH, PhD, Immunisation, Hepatitis and Blood Safety Department, Health Protection Agency, 61 Colindale Avenue, London NW9 5EQ, United Kingdom. E-mail:

© 2013 Lippincott Williams & Wilkins, Inc.