Results from a Prospective, International, Epidemiologic Study of Invasive Candidiasis in Children and Neonates
SourcePediatric Infectious Disease Journal, 31, 12, (2012), pp. 1252-1257
Article / Letter to editor
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Pediatric Infectious Disease Journal
SubjectN4i 2: Invasive mycoses and compromised host
BACKGROUND:: Candida species are the third most common cause of pediatric healthcareassociated bloodstream infection in the United States and Europe. To our knowledge, this report from the International Pediatric Fungal Network is the largest prospective, multi-center observational study dedicated to pediatric and neonatal invasive candidiasis. METHODS:: From 2007-2011, we enrolled 196 pediatric and 25 neonatal patients with invasive candidiasis. RESULTS:: Non-albicans Candida species predominated in pediatric (56%) and neonatal (52%) age groups, yet C. albicans was the most common in both groups. Successful treatment responses were observed in pediatric (76%) and neonatal patients (92%). Infection with C. parapsilosis led to successful responses in pediatric (92%) and neonatal (100%) patients, while infection with C. glabrata was associated a lower successful outcome in pediatric patients (55%). The most commonly used primary antifungal therapies for pediatric invasive candidiasis were fluconazole (21%), liposomal amphotericin B (20%), and micafungin (18%). Outcome of pediatric invasive candidiasis was similar in response to polyenes (73%), triazoles (67%) and echinocandins (73%). The most commonly used primary antifungal therapies for neonatal invasive candidiasis were fluconazole (32%), caspofungin (24%), and liposomal amphotericin B (16%) and micafungin (8%). Outcomes of neonatal candidiasis by antifungal class again revealed similar response rates amongst the classes. CONCLUSIONS:: We found a predominance of non-albicans Candida infection in children and similar outcomes based on antifungal class used. This international collaborative study sets the foundation for large epidemiologic studies focusing on the unique features of neonatal and pediatric candidiasis and comparative studies of therapeutic interventions in these populations.
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