Epidemiology of Invasive Fungal Disease in Children

Abstract

Considerable progress has been made in the prevention, diagnosis, and management of pediatric patients with invasive fungal disease (IFD). The reported decreasing trend in the incidence of invasive candidiasis (IC) over the past 15 years in both neonates and children has been encouraging. Nevertheless, due to the growing number of immunocompromised children at risk for IFD, this disease continues to be associated with significant morbidity and death and with increased financial burden to the health care system. Therefore, it is important to understand the contemporary epidemiology of IFD. Incidence rates of IFD in children are affected by geographical, population, and time variability. There is an ongoing effort to constantly document and update the incidence of IFD and species distribution among different pediatric populations as a means to direct preventative, diagnostic, and therapeutic resources to the most appropriate subset of patients. Children with a hematologic malignancy or a primary or secondary immunodeficiency, those undergoing solid organ or hematopoietic stem cell transplantation, and premature neonates are the major subsets of pediatric patients at risk of developing IFD. In this review, we focus on fungal disease epidemiology with a specific emphasis on the 2 most common pediatric IFDs, IC and invasive aspergillosis (IA).

Epidemiology of invasive fungal infections in immunocompromised children; an Australian national 10‐year review

“…Epidemiology of Candida infections is changing worldwide with increasing prevalence of non‐ albicans species . Of the Candida identified in our study, 70% were non‐ albicans , with C. parapsilosis being the most frequently isolated Candida overall.…”

“…The epidemiology of invasive fungal infections (IFI) in immunocompromised children continues to evolve alongside cancer treatment regimens and hematopoietic stem cell transplant (HSCT) protocols in conjunction with selective pressure from antifungal prophylaxis strategies and environmental influences . As such, the morbidity and mortality associated with IFIs in immunocompromised children remains a major concern …”

Epidemiological features of nosocomial candidaemia in neonates, infants and children: A multicentre study in Iran

“…The widespread use of broad‐spectrum antibiotics may also account for the increase in candidaemia cases in recent years . However, premature birth, prolonged stay at the intensive care unit (ICU) and immaturity are the main predisposing factors in neonates and children …”

Epidemiology, utilisation of healthcare resources and outcome of invasive fungal diseases following paediatric allogeneic haematopoietic stem cell transplantation

“…Bacterial, viral and fungal infections are frequently observed in children and adolescents post‐transplant . Invasive fungal disease (IFD) is a life‐threatening condition.…”

“…Early detection is crucial, but still difficult despite recent progress in the diagnosis of IFDs in immunocompromised hosts. The two most common paediatric IFDs are invasive candidiasis and invasive aspergillosis . However, data about the epidemiology of IFDs in paediatric stem cell transplant recipients and the utilisation of healthcare resources for prevention, diagnosis and management are limited and a subject of constant change.…”