Application of a standardized screening protocol for diagnosis of invasive mold infections in children with hematologic malignancies

Cohn, Shannon M.; Pokala, Hanumantha R.; Siegel, Jane D.; McClay, John E.; Léonard, David; Kwon, Jeannie K.; Timmons, Charles F.; Winick, Naomi J.

doi:10.1007/s00520-016-3367-z

Cited by 19 publications

(29 citation statements)

References 24 publications

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“…In the updated CPG, a revised weak recommendation against routine sinus imaging was made in the absence of localizing signs or symptoms based on the systematic review (Data Supplement). Among the five studies that described sinus findings, 118,122,123,125,126 sinus imaging was frequently abnormal in prolonged FN, and abnormalities did not distinguish between those with and without sinus IFD. It is a weak recommendation because studies directly addressing the usefulness of routine sinus CTs were limited.…”

Section: Recommendationsmentioning

confidence: 94%

“…A strong recommendation to perform lung CTs remained unchanged in the updated CPG. Of the nine studies evaluating lung CT [115][116][117][118][119][120][121][122][123] for the evaluation of IFD, lungs were usually the most frequent site of infection, and characteristic radiographic signs were often observed. A new weak recommendation for abdominal imaging even in the absence of localizing signs or symptoms was made with this CPG update, based on the systematic review (Data Supplement).…”

Section: Recommendationsmentioning

confidence: 99%

“…A new weak recommendation for abdominal imaging even in the absence of localizing signs or symptoms was made with this CPG update, based on the systematic review (Data Supplement). Among the four studies included, 118,[122][123][124] findings on imaging consistent with IFD were observed in many patients without localizing signs or symptoms. The Panel noted that the ideal imaging modality is not known, but ultrasound is readily available, is not associated with radiation exposure, and usually does not require sedation and thus, is likely preferable over CT or magnetic resonance imaging for abdominal assessment.…”

Section: Recommendationsmentioning

confidence: 99%

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Guideline for the Management of Fever and Neutropenia in Children With Cancer and Hematopoietic Stem-Cell Transplantation Recipients: 2017 Update

Lehrnbecher

Robinson²,

Fisher

et al. 2017

JCO

385

450

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Purpose To update a clinical practice guideline (CPG) for the empirical management of fever and neutropenia (FN) in children with cancer and hematopoietic stem-cell transplantation recipients. Methods The International Pediatric Fever and Neutropenia Guideline Panel is a multidisciplinary and multinational group of experts in pediatric oncology and infectious diseases that includes a patient advocate. For questions of risk stratification and evaluation, we updated systematic reviews of observational studies. For questions of therapy, we conducted a systematic review of randomized trials of any intervention applied for the empirical management of pediatric FN. The Grading of Recommendation Assessment, Development and Evaluation approach was used to make strong or weak recommendations and to classify levels of evidence as high, moderate, low, or very low. Results Recommendations related to initial presentation, ongoing management, and empirical antifungal therapy of pediatric FN were reviewed; the most substantial changes were related to empirical antifungal therapy. Key differences from our 2012 FN CPG included the listing of a fourth-generation cephalosporin for empirical therapy in high-risk FN, refinement of risk stratification to define patients with high-risk invasive fungal disease (IFD), changes in recommended biomarkers and radiologic investigations for the evaluation of IFD in prolonged FN, and a weak recommendation to withhold empirical antifungal therapy in IFD low-risk patients with prolonged FN. Conclusion Changes to the updated FN CPG recommendations will likely influence the care of pediatric patients with cancer and those undergoing hematopoietic stem-cell transplantation. Future work should focus on closing research gaps and on identifying ways to facilitate implementation and adaptation.

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Section: Recommendationsmentioning

confidence: 94%

Section: Recommendationsmentioning

confidence: 99%

Section: Recommendationsmentioning

confidence: 99%

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Guideline for the Management of Fever and Neutropenia in Children With Cancer and Hematopoietic Stem-Cell Transplantation Recipients: 2017 Update

Lehrnbecher

Robinson²,

Fisher

et al. 2017

JCO

385

450

View full text Add to dashboard Cite

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“…For example, a study with six out of nine children with ALL, fungal infection was progressive despite intravenous antifungals. The high percentage (21%) of death from invasive fungal infection among lethal infections in pediatric ALL individuals illustrates the relevance of fungi in this group of individuals [30].…”

Section: Discussionmentioning

confidence: 99%

Candida on oral cavity of pediatric individuals with ALL and its susceptibility to nystatin and amphotericin B

Monteiro

Ribeiro

Batista

et al. 2019

RGO, Rev. Gaúch. Odontol.

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Candida on oral cavity of pediatric individuals with ALL and its susceptibility to nystatin and amphotericin BCandida na cavidade oral de indivíduos pediátricos com LLA e sua susceptibilidade à nistatina e à anfotericina B ABSTRACT Objective: The aim of this study was to evaluate the prevalence of Candida colonizationon oral cavity of pediatric individuals with acute lymphocytic leukemia (ALL) and its susceptibility/resistance to nystatin and amphotericin B. Methods: This was a cross sectional study with observational, descriptive and analytic approach. Saliva was collected from40 individuals diagnosed with ALL and from40 healthy subjects, as a comparative group, matched by age and gender with ALL group. The mean age for both groups were 8 years-old. The isolation and identification of the Candidaspecies were performed using the CHROMagarCandidaTM and confirmed by polymerase chain reaction. The samples were subjected to antifungal susceptibility by microdilution assay for nystatin and amphotericin B. Salivary alterations and chemotherapy-induced oralmucositis were evaluated using modifiedOral Assessment Guide. Results: The positivity to Candida was higher inALL individuals (32.5%,13/40)than in a comparative group(2.5%, 1/40) (p<0.001). Candida albicans was the most prevalent strain (86.6%). The mucositis was directly associated with positive Candidacolonization (p=0.017) in the ALL group but not related with salivary alterations (p= 0.479). Six strains of C. albicans (54.5%), on ALL group, were resistant to nystatin oral mucositis in these individuals. C. albicans was the prevalent strain and most samples were resistant to antifungal agents tested, nystatin and amphotericin B. RESUMOObjetivo: o objetivo deste estudo foi avaliar a prevalência e colonização de Candida na cavidade oral de indivíduos pediátricos com leucemia linfocítica aguda (LLA) e sua susceptibilidade/resistência à nistatina e à anfotericina B. Métodos: estudo transversal observacional com abordagem descritiva e analítica. A saliva foi coletada de 40 indivíduos diagnosticados com LLA e de 40 indivíduos saudáveis, como grupo comparativo, combinados por idade e sexo com o grupo LLA. A idade média para ambos os grupos foi de 8 anos de idade. O isolamento e a identificação das espécies de Candida foram realizados utilizando o CHROMagarCandidaTM e confirmados pela reação em cadeia da polimerase. As amostras foram submetidas a susceptibilidade antifúngica por meio de ensaio de microdiluição para nistatina e anfotericina B. As alterações salivares e a mucosite oral induzida por quimioterapia foram avaliadas utilizando o Guia de avaliação modificada. Resultados: A positividade para Candida foi superior aos indivíduos in situ (32,5%, 13/40) do que em um grupo comparativo (2,5%, 1/40) (p <0,001). Candida albicans foi a cepa mais prevalente (86,6%). A mucosite foi diretamente associada à colonização positive por Candida (p = 0,017) no grupo LLA, mas não relacionada com alterações salivares (p = 0,479). Seis estirpes de C. albicans (54,5%), no grupo LLA, era...

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“…3 My hope is that radiologists will do a better job of educating ordering providers regarding the utility of this test in this setting. Bedside sinus endoscopy is an effective alternative approach 4 that offers the opportunity for sampling and avoids radiation.…”

mentioning

confidence: 99%

Paranasal Sinus CT Is of Variable Value in Patients with Pediatric Cancer with Neutropenic Fever

Pfeifer

2019

AJNR Am J Neuroradiol

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Application of a standardized screening protocol for diagnosis of invasive mold infections in children with hematologic malignancies

Cited by 19 publications

References 24 publications

Guideline for the Management of Fever and Neutropenia in Children With Cancer and Hematopoietic Stem-Cell Transplantation Recipients: 2017 Update

Guideline for the Management of Fever and Neutropenia in Children With Cancer and Hematopoietic Stem-Cell Transplantation Recipients: 2017 Update

Candida on oral cavity of pediatric individuals with ALL and its susceptibility to nystatin and amphotericin B

Paranasal Sinus CT Is of Variable Value in Patients with Pediatric Cancer with Neutropenic Fever

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