OBJECTIVE: Neutropenia is one of the risk factor of invasive candida infection which significantly cause mortality and morbidity in pediatric patients with malignancy. Conventional mycological blood culture is the gold standard to diagnose invasive candida infection. But, this method require a long time to proceed and has low sensitivity. In mean time, predictive scoring could be used to diagnose invasive candida infection. Candida score is one of the promising method. Yet, there are still limited researches regarding this issue in pediatric patient. This study was aimed to evaluate candida score among neutropenic patients.
METHOD: A cross sectional study was conducted from April to May 2019 in Pediatric ward of Saiful Anwar Hospital Malang. All hospitalized patients with neutropenia are included in the study. The Candida score was calculated at the onset of neutropenia. Candida score > 3 is strongly suggestive of invasive candida infection. Meanwhile score < 3 has low predictive value and giving antifungal therapy were not recommended. The relationship of the invasive candida infection and candida score was studied using Chi-square correlation test.
RESULTS: A total 51 patients were enrolled in this study, of whom 22 patients had candida score >3 (19 patients have severe neutropenia and 3 patients have moderate neutropenia) and 29 patients had candida score < 3 (9 patients have severe neutropenia and 20 patients have moderate neutropenia). The P value was < 0.050 indicating there is a significant correlation between candida score and invasive candida infection in pediatric neutropenia patient. The odds ratio was 0.071 which suggests that individual with severe neutropenia is 0.071 times more likely to develop invasive candida infection.
CONCLUSION: Severe neutropenic patients are likely to develop invasive candida infection during hospitalization. The results of our study confirm that candida score has significant predictive value to diagnose invasive candida infection in pediatric neutropenia patients.