Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Mar;68(3):e70041.
doi: 10.1111/myc.70041.

The Paediatric European Confederation of Medical Mycology (ECMM) Quality (Paed-EQUAL) Candida Score for the Management of Candidaemia in Children and Neonates

Abhijit M Bal  1   2 , Zoi Dorothea Pana  3 , Fabianne Carlesse  4   5 , Aleksandra Marek  2   6 , Danila Seidel  7   8 , Katrin Mehler  9   10 , Sarina Butzer  9 , Rosanne Sprute  7   8   11 , Jannik Stemler  7   8   11 , Daniel Ludwig-Bettin  9 , Andreas H Groll  12 , Oliver A Cornely  7   8   11 , Sibylle C Mellinghoff  7   8   11
Affiliations
Review

The Paediatric European Confederation of Medical Mycology (ECMM) Quality (Paed-EQUAL) Candida Score for the Management of Candidaemia in Children and Neonates

Abhijit M Bal et al. Mycoses. 2025 Mar.

Abstract

Candidaemia in children is associated with high mortality. The epidemiology of Candida bloodstream infection is changing with rising rates of fluconazole resistance worldwide and the emergence of novel multidrug-resistant species such as Candida auris, which is associated with outbreaks. Guidelines on the management of candidaemia emphasise identification of species and determination of antifungal susceptibility to guide appropriate treatment, performing relevant investigations to rule out deep-seated infection, and removal of central venous catheters. However, it is difficult to apply guidelines in routine practice. The European Confederation of Medical Mycology candidaemia scoring tool (the EQUAL score) has facilitated adherence to guidelines by using a point-based system. We have designed a point-based paediatric EQUAL (paed-EQUAL) score tool for the management of candidaemia in neonates and children. The paed-EQUAL scoring tool can be applied to improve guideline adherence and facilitate antifungal stewardship.

Keywords: EQUAL score; candidaemia; central venous catheter; disseminated candidiasis; echocardiogram; guideline adherence; ophthalmoscopy; scoring tool.

PubMed Disclaimer

References

    1. A. Warris, Z. D. Pana, A. Oletto, et al., “Etiology and Outcome of Candidemia in Neonates and Children in Europe: An 11‐Year Multinational Retrospective Study,” Pediatric Infectious Disease Journal 39, no. 2 (2020): 114–120, https://doi.org/10.1097/INF.0000000000002530.
    1. L. Ferreras‐Antolín, M. Sharland, and A. Warris, “Management of Invasive Fungal Disease in Neonates and Children,” Pediatric Infectious Disease Journal 38, no. 6S Suppl 1 (2019): S2–S6.
    1. T. E. Zaoutis, P. A. Prasad, A. R. Localio, et al., “Risk Factors and Predictors for Candidemia in Pediatric Intensive Care Unit Patients: Implications for Prevention,” Clinical Infectious Diseases 51 (2010): e38–e45.
    1. E. Mantadakis, Z. D. Pana, and T. Zaoutis, “Candidemia in Children: Epidemiology, Prevention and Management,” Mycoses 61, no. 9 (2018): 614–622, https://doi.org/10.1111/myc.12792.
    1. Z. D. Pana, E. Roilides, A. Warris, A. H. Groll, and T. Zaoutis, “Epidemiology of Invasive Fungal Disease in Children,” Journal of the Pediatric Infectious Diseases Society 6, no. suppl_1 (2017): S3–S11.

LinkOut - more resources