Invasive fungal infections in pediatric oncology
- 11 February 2011
- journal article
- research article
- Published by Wiley in Pediatric Blood & Cancer
- Vol. 56 (7), 1092-1097
- https://doi.org/10.1002/pbc.23005
Abstract
Background Data on the epidemiology and outcome of invasive fungal infections in children with cancer are limited. The aim of the study was to delineate the epidemiologic, clinical features, risk factors, and outcome of invasive fungal infections in this population. Procedure The medical records of all children with malignancies diagnosed with an invasive fungal infection in 1998–2006 at a tertiary pediatric medical center were reviewed for demographic, clinical, and laboratory data. Invasive fungal infection was diagnosed according to the latest EORTC/MSG criteria. Results Of the 1,047 children hospitalized in the hematology/oncology department during the study period, 75 (7.2%) were diagnosed with a proven (n = 16, 21.3%), probable (n = 18, 24%), or possible (n = 41, 54.7%) invasive fungal infection. Fifteen (20%) had candidemia (non-albicans in 60%), and 60 (80%) had a mold infection (non-Aspergillus in 55%). Crude mortality was 21.7%. The most common underlying diseases were myeloid leukemia (n = 26, 34.7%) and acute lymphoblastic leukemia (n = 24, 32%). Compared to other malignancies, acute myeloid leukemia was significantly associated with the development of invasive fungal infections. Profound neutropenia and high treatment intensity were present in 89% and 73% of patients with IFI respectively. Conclusions The current mortality rates of invasive fungal infection in children with cancer are lower than previously reported in children and adults. However, the proportion of non-albicans candidemia is increasing, and non-Aspergillus molds are emerging as important pathogens, which may have important implications for prophylaxis and empiric therapy. Improved prevention, early detection, and advanced treatment strategies are needed to improve the outcome. Pediatr Blood Cancer 2011;56:1092–1097.Keywords
Funding Information
- Gilead Sciences Research Foundation, Foster City, CA
This publication has 24 references indexed in Scilit:
- Outcome and Medical Costs of Patients with Invasive Aspergillosis and Acute Myelogenous Leukemia–Myelodysplastic Syndrome Treated with Intensive Chemotherapy: An Observational StudyClinical Infectious Diseases, 2008
- Invasive fungal infections in pediatric leukemia patients receiving fluconazole prophylaxisPediatric Blood & Cancer, 2008
- The Clinical Feature of Invasive Fungal Infection in Pediatric Patients With Hematologic and Malignant DiseasesJournal of Pediatric Hematology/Oncology, 2008
- Factors Associated with Overall and Attributable Mortality in Invasive AspergillosisClinical Infectious Diseases, 2008
- Fungal Infections in Children With CancerThe Pediatric Infectious Disease Journal, 2006
- The Epidemiology and Attributable Outcomes of Candidemia in Adults and Children Hospitalized in the United States: A Propensity AnalysisClinical Infectious Diseases, 2005
- Invasive Fungal Infections in Pediatric Oncology PatientsJournal of Pediatric Hematology/Oncology, 2005
- A Prospective Observational Study of Candidemia: Epidemiology, Therapy, and Influences on Mortality in Hospitalized Adult and Pediatric PatientsClinical Infectious Diseases, 2003
- Candidemia at a Tertiary-Care Hospital: Epidemiology, Treatment, Clinical Outcome and Risk Factors for DeathEuropean Journal of Clinical Microbiology & Infectious Diseases, 2002
- Aspergillosis in Children with Cancer: A 34-Year ExperienceClinical Infectious Diseases, 1999