RESUMEN

BACKGROUND/PURPOSE: Invasive candidiasis is a severe infectious disease that could lead to mortality in critically ill children. METHODS: We collected data regarding demographics, underlying diseases, predisposing factors, outcomes for pediatric patients with candidemia at a medical centre in Taiwan from 2011 to 2017. RESULTS: Fifty-eight patients with 60 candidemia episodes were diagnosed. The 3 most common species were Candida albicans (42%), Candida parapsilosis (25%) and Candida tropicalis (23%). C. parapsilosis predominantly infected infants and neonates (median age: 0.8 years, range: 0.1-14.5). Cases with C. tropicalis had significantly higher rates of multidrug resistance (p = 0.011) and disseminated candidiasis (p = 0.025) compared with other cases. The all-cause mortality rate was 43%, and the candidemia-related mortality rate was 29%. Pediatric sequential organ failure assessment score >8 [adjusted odds ratio (aOR) 66.2, 95% CI 4.03-1088.5] and posaconazole resistance (aOR 33.57, 95% CI 1.61-700.3) were the most significant risk factors associated with candidemia-related mortality, whereas treatment with effective antifungal agents within 48 h (aOR 0.07, 95% CI 0.01-0.9) was the only significant protective factor. CONCLUSION: Candidemia-related mortality was related to azole resistance; therefore, empirical therapy with echinocandin or amphotericin B is recommended pending species and susceptibility results.

Asunto(s)

Candidemia , Candidiasis , Antifúngicos , Candida , Niño , Humanos , Lactante , Recién Nacido , Pruebas de Sensibilidad Microbiana

RESUMEN

We present wide electrical tuning of microring resonators with auto-realigned nematic liquid crystal (NLC) cladding. By applying electric field, homeotropically-aligned negative Δε NLC with non-rubbed alignment layers is auto-realigned along the microring waveguide due to the protruding of the ridge structure. The consistent cladding index distribution along the microring waveguide produces effective tuning of the resonant wavelength. It achieves a large tuning range of 13nm for TM mode and 2.1nm for TE mode. The NLC reorientation characteristics are investigated by minimizing Oseen-Frank energy. The proposed microring resonator owns the features of large tuning range and bi-polarization wavelength tuning.