Candidemia in Pediatric Hematology–Oncology Patients: Risk Factors, Microbiological Characteristics, and Predictors of Mortality
Mehmet Erinmez,1, Ayţe Ceyda Ören2, Mustafa Sađlam1, Yasemin Zer11Department of Medical Microbiology, Gaziantep University Faculty of Medicine, Gaziantep, Türkiye, 2Department of Pediatric Hematology Oncology, Gaziantep University Faculty of Medicine, Gaziantep, Türkiye
Objectives: Invasive fungal infections remain a major cause of morbidity and mortality in pediatric hematology–oncology patients, with candidemia representing the most common invasive fungal infection in this population. However, data on clinical characteristics, species distribution, and outcomes remain limited. This study evaluates the clinical and microbiological features, antifungal susceptibility patterns, and outcomes of candidemia in pediatric hematology–oncology patients at a tertiary care center. Methods: This retrospective cohort study included pediatric patients with hematologic or solid malignancies hospitalized between 2020 and 2025 and evaluated clinical characteristics, candidemia occurrence, Candida species distribution, antifungal susceptibility, and 30-day mortality. Results: Among 926 pediatric oncology patients, candidemia occurred in 8.5% of cases and was associated with younger age, neutropenia, intensive care unit admission, and increased mortality, while sex and type of malignancy showed no significant association. Multivariate analysis identified younger age, neutropenia, and intensive care unit admission as independent predictors of candidemia, whereas candidemia independently increased the risk of 30-day mortality more than twofold. Candida albicans was the most common isolate, followed by non-albicans species, and amphotericin B susceptibility was largely preserved across isolates. Conclusion: Pediatric hematology–oncology patients with candidemia face significantly increased morbidity and mortality, with independent risk factors including younger age, neutropenia, and intensive care admission, and mortality predictors including younger age, female sex, thrombocytopenia, and candidemia itself. Non-albicans Candida species accounted for over half of the isolates, while amphotericin B remained highly effective. These findings highlight the need for early risk identification, targeted prophylaxis, and prompt antifungal therapy in this vulnerable population. Keywords: Amphotericin B, Invasive Fungal Infections, Neutropenia, Non-albicans Candida
Cite This Article
Erinmez, M, Ören A, Sađlam M, Zer Y. Candidemia in Pediatric Hematology–Oncology Patients: Risk Factors, Microbiological Characteristics, and Predictors of Mortality. EJMI. 2026; 10(2): 131-138
Corresponding Author: Mehmet Erinmez,