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Clinical features in proven and probable invasive fungal disease in children and adolescents at a pediatric referral center: a 5-year experience

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World Journal of Pediatrics 2019年第3期15卷 270-275页

作者： Kenji Kishimoto Masashi Kasai Noriko Kawamura Yusuke Ito Makiko Yoshida daiichiro hasegawa Keiichiro Kawasaki Yoshiyuki Kosaka Department of Hematology and Oncology Children’s Cancer CenterKobe Children’s HospitalMinatojima—Minamimachi 1—6-7Chuo—kuKobe 650—0047 Japan Department of Infectious Disease Kobe Children’s Hospital KobeJapan Department of Clinical Laboratory Kobe Children’s HospitalKobeJapan Department of Diagnostic Pathology Kobe Children’s HospitalKobeJapan Department of Pediatrics Kita—Harima Medical Center KobeJapan

Background There is limited information concerning the overall epidemiology of invasive fungal disease (IFD) in *** aim of this study was to clarify the clinical features of IFD in a tertiary pediatric care *** Patients diagnosed with proven or probable IFD at our hospital between 2011 and 2015 were retrospectively *** and probable IFD were defined according to the European Organization for Research and Treatment of Cancer/Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group *** with possible IFD were *** The incidence of proven or probable IFD was 26 of 20,079 hospitalized patients (0.13%).The predominant underlying disease was malignancy (54%) and congenital anomaly (27%).The most common diagnosis was candidemia among the patients with proven IFD (8 of 13,62%).All the isolated pathogens in the candidemia patients were non-albicans Candida *** most common site of infection was the lungs in patients with probable IFD (11 of 13 patients,85%).In probable IFD episodes,positive β-D-glucan and galactomannan were found in 12 of 13 (92%) and 5 of 13 (38%) patients,*** but one patient (96%) received empirical antifungal *** patients underwent surgical resection of residual *** overall mortality was 23% and the attributable mortality of IFD was 12%.Conclusion Our results suggest the emergence of non-albicans Candida species as important pathogens in childhood IFD.

关键词： Children Invasive fungal disease Incidence Mortality

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