The aim of this study was to evaluate the Candida species, predisposing factors, antifungal treatment approaches, and clinical outcomes of invasive Candida infections (ICIs) in a tertiary pediatric intensive care unit (PICU). A retrospective study was performed from January 2008 to January 2019 including 102 children with ICIs who were admitted to a university hospital in southeastern Turkey. Positive blood cultures were detected in 43 (42.1%) patients, and positive urine cultures were detected in 59 (57.8%). According to our results, Candida albicans (42.2%) was the most common species for all isolates followed by C. parapsilosis (17.6%). In our patient population, non-albicans Candida species were dominant (57.8%) in all isolates. The most common facilitating factor in our study was the use of mechanical ventilator support (87.3%). The mortality rate of our patients with ICIs was 13.7%. Candida albicans was found to have the highest mortality rate among all Candida species (30.7%). When we compared patients with C. albicans and those with non-albicans Candida species in terms of risk factors, we detected a significant difference between the two groups for total parenteral nutrition use (p = 0.027). Fluconazole was the most preferred (58.8%) treatment option in our PICU for ICIs. Our results showed an increased trend in micafungin use in recent years. ICIs are a significant problem due to the high mortality and morbidity rates in critically ill pediatric patients in PICUs. In recent years, an increase in Candida infections caused by non-albicans Candida species has been reported. Multicenter prospective studies are needed to determine the risk factors for ICIs.
While leukemia is responsible for 25-30% of childhood cancers, acute leukemia accounts for about 97% of leukemia. In children younger than 15 years, Acute lymphoblastic leukemia is about five times more common than acute myeloid leukemia. The annual incidence of acute lymphoblastic leukemia in Turkey is 1.5/100,000. While treatment response and survival rates in acute lymphoblastic leukemia did not reach 10% in 1960s, approximately 80-90% of patients can be remitted with treatment protocols today. In the treatment of high-risk patients, more agents are given at higher doses and for longer periods. In appropriate cases, stem cells are transplanted. Key words: Lymhocytic leukemia, epidemiology, classification, prognosis ÖZ Çocukluk çağı kanserlerinin %25-30'unu lösemiler oluştururken, lösemilerin yaklaşık %97'sinden akut lösemiler sorumludur. On beş yaşından küçük çocuklarda akut lenfoblastik lösemi, akut myeloblastik lösemiye göre yaklaşık beş kat daha sık görülmektedir. Akut lenfoblastik lösemilerin Türkiye'de yıllık insidansı 1.5/100.000'dir. Akut lenfoblastik lösemide tedaviye yanıt ve sağ kalım oranları 1960'lı yıllarda %10 düzeyine ulaşmaz iken, bugün tedavi protokolleri ile hastaların yaklaşık olarak %80-90'ında remisyon sağlanabilmektedir. Yüksek riskli hastaların tedavisinde daha fazla ajan daha yüksek dozlarda ve daha uzun süre verilmektedir. Uygun vakalarda kök hücre nakli yapılmaktadır. Anahtar kelimeler: Lenfositik lösemi, epidemiyoloji, sınıflandırma, prognoz,
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