الفهرس 
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Abstract
The incidence of invasive fungal infection (IFI) is increasing worldwide, particularly in critically ill non-neutropenic patients. It represents a serious and a challenging problem for both patients and physicians (El-beleidy et al., 2012).
The literatures which are concerned about prevalence, early diagnosis, and treatment of IFI in critically ill non-neutropenic pediatric patients are still unsatisfactory. Also risk factors in children with Candidaemia are still poorly defined (Festekjian and Neely, 2011).
So this study aimed to find answers for these important enquiries concerning fungal infections in the critically ill pediatric patients. This study illustrates the fungal infections in a cohort of 50 critically ill children who were admitted to pediatric intensive care unit of Pediatric Hospital, Minia University, during a period of 12 months who were found to be at high risk for fungal infection.
All patients involved in the study had been subjected to full medical history, thorough clinical examination, (PRISM III) score during the first 24 hours of admission, routine laboratory investigations.
Collected blood sample were used for aerobic cultures first followed by other blood work (i.e. Chemistry, Hematology, etc.). It was cultured on blood, macConkey agars for identification of bacterial pathogens and Sabouraud dextrose agar (SDA) for the identification of fungi according to the microscopic picture and colonial morphology. Serum samples were examined for fungal antigens using ELISA technique for Candida mannan antigens.
Invasive Candidiasis was diagnosed in 52% of critically ill children. Median age of study group was 9 months. All the patients were assessed by PRISM score with mean for positive and negative groups (29.23 ± 10.37, 26.25 ± 8.64; p 0.277) respectively.
One of the highly significant risk factor in the study was the number of antibiotics used for treatment of the cases. It was 2.33± 0.48 in negative cases and 2.73 ± 0.6 in positive cases with p value 0.014.
Other risk factors included neutropenia (p=0.420) and thrombocytopenia (P=0.877) were insignificant.
Relation between Candida antigen by ELISA and fungal culture was insignificant (P=0.491). All the 24 negative cases by ELISA were negative by culture (100%). The number of positive cases by ELISA was 26, 24 cases of them were negative by culture (92.3%) however only 2 cases of them (7.7%) showed a positive culture growth. Also Candida antigen titre by ELISA was highly significant (p <0.001).
Finally, ROC Analysis showed the following; the sensitivity of fungal infection by Candida species was 100 %, and specificity was 50% with non significant p value =0.235.