Candidemia in Children with Malignancies: Report from the Infection Working Group of the Hellenic Society of Pediatric Hematology-Oncology

Abstract

Candidemia is an important cause of morbidity and mortality especially in immunocompromised and hospitalized patients. We retrospectively collected data of candidemia cases that occurred in the seven Hematology-Oncology Departments/Units of Greece and the Stem Cell Transplant Unit between 2015 and 2019. In total, 19 episodes of candidemia in 19 patients were recorded. The majority of the patients (78.9%) had at least one risk factor for candidemia. The most frequent risk factors associated with candidemia observed in our patients were prolonged duration of hospitalization (30 days, range 1–141), presence of a central venous catheter at diagnosis of candidemia (73.7%) and antibiotics use during the last two weeks (84.2%). Candida parapsilosis was the most common species isolated accounting for 42.1%, followed by C. albicans (26.3%) and C. famata (15.8%). Nearly all of the patients (84.2%) received antifungal monotherapy with liposomal amphotericin B or echinocandins. The central venous catheter was removed in 78.6% of patients and the median time between the first positive blood culture and catheter removal was 3 days (range 1–9). Mortality at 28 days was 26.3%. In conclusion, a predominance of non-albicans species was observed in our study in conformity with the global trend.

The evaluation of Candida-related central line-related bloodstream infections in pediatric cancer patients: A pre- and post-intervention study

“…Due to an increase in life expectancy in the high-risk population, such as children with immunosuppressed conditions and cancer patients, candida infections are becoming a more common pathogen for bloodstream infections connected with healthcare. Similar to earlier research (Vasileiou et al, 2020), non-albicans Candida species—particularly C.parapsilosis —were the most prevalent isolated species in the current investigation. A prolonged usage of central venous catheters was found to be highly associated with C.parapsilosis (Trofa et al, 2008) According to Devrim et al 2018, 2020), C. parapsilosis was the second most prevalent microbe in the pediatric hematology-oncology unit at the same study center.…”

Invasive fungal disease in children with solid tumors: An Australian multicenter 10‐year review

“…Recent epidemiological studies of IFD pathogens have shown a higher proportion of non-Candida albicans yeasts and emergence of non-Aspergillus molds. 3,10,17,19,[26][27][28][29] In this cohort of children with solid malignancies, Candida parapsilosis predominated, and Aspergillus species and non-Aspergillus molds were rare. Notably, amongst patients who developed IFD in our study, 35.0% were receiving fluconazole antifungal prophylaxis.…”

Isolation and identification of Wickerhamiella tropicalis from blood culture by MALDI-MS

“…The immunocompromised patients have possibilities of severe infections caused by environmental fungi including Wickerhamiella species. The mortality of non- Candida albicans species in pediatric patients with malignancies was 26.3% between 2015 and 2019 ( Vasileiou et al., 2020 ). The previous studies reported that the 5 patients with W. pararugosa bloodstream infections were immunocompromised because of malignancy, sarcoma, surgery, and leukemia, and 2 of the 5 patients could not be cured ( Nasri et al., 2023 ).…”