Incidence of Invasive Fungal Infections in Pediatric Hematology and Oncology Patients in Period 2002 – 2010

Ref ID: 18720

Author:

V. Chrenkova, MD – physician1, P. Hubacek, MD, Ph.D. – Research Assistant 2, P. Sedlacek, MD, PhD – Professor 2, P. Keslova, MD – physician 2, E. Kabickova, MD, PhD – Research Assistant 2, E. Mejstrikova, MD, PhD – Research Assistant 2, V. Smelhaus,

Author address:

1Motol Univ. Hosp., Prague, Czech Republic, 2Charles Univ. 2nd Faculty of Med. and Motol Univ. Hosp., Prague, Czech Republic.

Full conference title:

52nd Annual ICAAC

Date: 9 September 2014

Abstract:

Background: Data on invasive fungal diseases (IFD) in the hemato-oncological pediatric patients are limited. We performed retrospective analysis of IFD incidence in our patients at risk. Methods: We analyzed patients treated in Department of Pediatric Hematology and Oncology, in Motol University Hospital from I/2002 to XII/2010 and stratified them into risk groups (high risk – HR x low risk – LR) according to the ECIL 4 guidelines. The detected IFD cases were analyzed by the use of EORTC/MSG criteria and the incidence of proven and probable IFD in HR and LR group was calculated using basic statistical methods. Results: There have been 621 patients treated by 447 HR and 296 LR treatment courses during the selected period. 36 cases of proven/probable IFD were detected (26 in HR episodes – 5.8 % and 10 in LR – 3.4 %): 15 aspergilloses, 13 candidiases, 7 mucormycoses and 1 hormographiella/coprinus, this represents 42 %, 36 %, 19 % and 3 % of IFD respectively. The incidence was 5.8 % in HR group (27 cases) and 3.4 % in LR group (10 cases). There was no significant difference in number of patients in the selected period. The incidence of IFD was 5.6 % in allogeneic transplant recipients and 5.3 % in AML, 5.9 % in ALL and 4.7 % in NHL. The incidence of mucormycosis was found significantly higher than aspergillosis in 2008-2010 (p=0.02, Fisher’s exact test). The mortality rate of IFD was 52.8 % (47% of aspergilloses, 46 % of candidiases and 71 % of mucormycoses). Conclusions: The high rate of mucormycosis of 18.9 % of IFD and significant increase of its incidence during last years could be related to the reconstruction works started in 2006 with the maximum of activity in 2008. The influence of azoles in prophylaxis and the use of more aggressive treatment courses are to be evaluated. Acknowledgements: The data were partially collected in coordination with Czech Leukemia Group for Life and FIND database. Supported by Institutional Science Support of University Hospital Motol 00064203

Abstract Number: T-344

Conference Year: 2012

Link to conference website: NULL

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