Incidence of Fungal Infections in Pediatric Patients with Hematologic Neoplasms

Abstract

Background: Fungal infections are one of the most important causes of morbidity and mortality in patients with hematological disorders. The frequency of these infections has increased during the past decades. Objectives: The rate of fungal infections was investigated in pediatric patients with hematological disorders, using traditional and real-time PCR methods, in order to establish proper management of these patients. Methods: Over a 13-month period, 86 patients with hematological disorders were admitted and were kept under observation for the development of fungal infections. Fungal colonization was determined and clinical samples were examined by direct microscopic examination and culture. Blood specimens were cultured by bedside inoculation into a BACTEC medium. The results of the pathology smear were collected from the patients' records. Real-time PCR was performed on all patients' sera to diagnose invasive candidiasis and aspergillosis. Results: Candida colonization was seen in 42 (48.8%) and oral candidiasis was diagnosed in 7 (8%) patients. The incidence of invasive fungal infections was 16.3% (14/86) with a mortality rate of 50% in pediatric patients. The etiologic agents were Candida albicans in 5 cases, Aspergillus flavus in 3, and Aspergillus fumigatus, Fusarium, Alterneria and Mucor, each in 1 case. In 2 cases with liver abscess, only Candida PCR was positive. Fungemia was observed in 4 patients. Conclusions:The rate of invasive fungal infections in our study was high. Early and accurate detection of these infections could result in a better outcome. In critical ill cases where only blood samples are available, molecular methods such as PCR could be more effective than culture for the detection of etiologic agents.

Comparative Evaluation of Conventional and Nanosilver-Containing Leucocyte and Platelet-Rich Fibrin/Biomaterial in the Anti-Biofilm Formation of Standard Species of Candida and Streptococcus

“…Candida species are colonized organisms in some parts of the human body; in immunocompromised patient's postsurgery, they can pass through the natural body barriers to cause disseminated infections with high morbidity and mortality. Oral candidiasis was diagnosed in 8% of the pediatric patients, and 46.8% of the patients with hematologic disorders were colonized with Candida species (23,24). Candida albicans is the most commonly implicated organism recovered from 60% of dentate patient's mouth over the age of 60 and 50.5% of Candida species isolated from the oral cavity of liver transplant recipients (25)(26)(27).…”

Fungi Identified in Patients with Recurrent Lung Disorders

“…Candida species is controversial and the isolation of Candida species from the respiratory tract secretions is not clinically significant in many cases and do not need to be treated. However, the isolation is important because in patients with Candida colonization, the rate of systemic candidiasis increases (17). Treatment of all patients colonized with this organism may increase the risk of resistance to antifungal agents, leading to inappropriate costs.…”

Epidemiology of Fungal Colonization in Children Treated at the Department of Oncology and Hematology: Single-Center Experience

“…The majority of epidemiological data on this topic has come from case studies or single-center studies concerning a single fungal species or examining specific populations [ 10 , 11 , 12 , 13 , 14 , 15 , 16 ]. Many researchers have investigated a single fungal species in studies published over 10 years ago [ 17 , 18 , 19 , 20 , 21 ].…”