Biotype

All pediatric patients with candidemia aged less than 18 years old and admitted to Chang Gung Memorial Hospital (CGMH) between January 2005 and December 2020 were enrolled and reviewed. The Linkou CGMH is the largest, university-affiliated teaching hospital in Taiwan, and the pediatric department of Linkou CGMH has 550 beds. The pediatric ICU and three NICUs have a total of 20 beds and 107 beds, respectively. Additionally, there is a specialized pediatric hematology/oncology ward on the sixth floor. In our institute, all blood cultures are processed using the BACTEC 9240 (Becton Dickinson Microbiology Systems, Franklin Lakes, NJ, USA). All the samples that have been sent to the laboratory are taken in a standard manner in terms of sampling criteria. During the study period, all Candida isolates of pediatric candidemia were retrieved from the central laboratory and re-identified using Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF, Bruker Biotype, software version 3.0, USA). This study was approved by the institutional review board of the CGMH (certificate number: 202201214B0) and a waiver of informed consent was also approved for anonymous data collection and the retrospective design of this study.

Consortium samples were diluted (diluted 100–10,000 times). The following differential diagnostic media were seeded: saline mannitol agar, Uroselect (Himedya, Thane West, Maharashtra, India). Identification of the grown bacteria was carried out with using MALDI-TOF mass-spectrometry with biotype Bruker Daltonics, Bremen, Germany.