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INVASIVE FUNGAL DISEASE IN A PEDIATRIC HEMATOLOGY AND ONCOLOGY UNIT: A 14-YEAR PERIOD REVIEW
  • +6
  • Laura Calle-Miguel,
  • Carmen Garrido,
  • Begoña Santiago-Garcia,
  • Martha Patricia Moreno Santos,
  • Henar Gonzalo Pascual,
  • Beatriz Ponce Salas,
  • Cristina Beléndez,
  • Maria Navarro Gómez,
  • Elena Rincon-Lopez
Laura Calle-Miguel
Hospital General Universitario Gregorio Maranon

Corresponding Author:[email protected]

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Carmen Garrido
Hospital General Universitario Gregorio Maranon
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Begoña Santiago-Garcia
Hospital General Universitario Gregorio Maranon
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Martha Patricia Moreno Santos
Hospital General Universitario Gregorio Marañón
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Henar Gonzalo Pascual
Hospital General Universitario Gregorio Maranon
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Beatriz Ponce Salas
Hospital General Universitario Gregorio Maranon
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Cristina Beléndez
Hospital General Universitario Gregorio Maranon
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Maria Navarro Gómez
Hospital General Universitario Gregorio Maranon
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Elena Rincon-Lopez
Hospital General Universitario Gregorio Maranon
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Abstract

BACKGROUND. Invasive fungal disease (IFD) is a significant cause of morbidity and mortality in immunosuppressed children. We aim to describe the epidemiology and clinical parameters of IFD in a Pediatric Hematology-Oncology Unit (PHOU) with an increasing activity during the last 14 years. METHODS. We retrospectively reviewed the medical records of children (up to 18 years old) admitted for IFD to the PHOU of a tertiary hospital in Madrid (Spain), between 2006-2019. Epidemiological, diagnostic and therapeutic parameters were compared according to the type of infection, study period (considering 3 equivalent time fractions) and outcome. RESULTS. Twenty-eight episodes of IFD occurred in 27 out of 471 children at risk (13 males, median 10 years old). Five episodes of candidemia (all in the first period) and 23 bronchopulmonary mold diseases were registered. Six (21.4%), eight (28.6%) and 14 (50%) episodes met criteria for proven, probable and possible IFD, respectively. Most episodes (71.4%) occurred in high-risk children receiving antifungal prophylaxis. Eight children required intensive care and six died during treatment. Mold infections occurred in older children (126 vs. 21 months; p=0,045), increased over time (p=0.002) and were more common in high-risk compared to low-risk children (87% vs. 0%; p=0.001). There were no differences in mortality rates between periods, types of infection or underlying conditions. CONCLUSIONS. Yeast infections decreased within the study time and mold infections were more frequent in high-risk patients. A rising activity in our PHOU and an increase in the complexity of pathologies were not followed by an increase in mortality rates.