invasive aspergillosis in children in Saint-Petersburg

Климко, Н Н; Хостелиди, С Н; Борзова, Ю В; Шадривова, О В; Десятик, Е А; Popova, M.; Волкова, А. Г.; Богомолова, Т С; Araviiskii, R. A.; Игнатьева, С М; Зубаровская, Л. С.; Kolbin, A. S.; Бойченко, Э. Г.; Medvedeva, Nadezhda; Белогурова, М. Б.; Афанасьев, Б. В.

doi:10.17650/2311-1267-2014-0-3-37-43

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“…при гистологическом исследовании, микроскопии или посеве материала из очагов поражения в целях верификации -«золотой стандарт» диагностики ИА, тем не менее зачастую является сложной задачей у детей в периоде постцитостатической цитопении ввиду ограничения возможностей использования инвазивных процедур. Наиболее частые возбудители ИА -A. fumigatus (59,0 %), Aspergillus flavus (15,7 %), Aspergillus terreus (4,7 %) и Aspergillus niger (4,7 %) [4,5,15,20,23,26]. В ряде публикаций имеются данные о различной частоте выявления A. terreus -от 3,0 до 12,5 % [10,23], который по сравнению с другими возбудителями ИА ассоциирован с более высоким уровнем летальности [23,35].…”

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Invasive aspergillosis in children and adolescents with solid tumors: clinical cases and registry analysis

et al. 2019

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We presented two cases of invasive aspergillosis (IA) in children with solid tumors, data of IA patients register, and a literature review. In theregister of patients with IA (1997–2018), we found 57 patients with IA from 0 to 18 years. It was established that the number of patients with solid tumors was 15.7 %. Background diseases were: central nervous system tumors – 33.5 %, neuroblastoma – 33.5 %, osteosarcoma – 11.0 %, Wilms tumor – 11.0 %, hemangioblastoma – 11.0 %. Chemotherapy-induced neutropenia was reported in 100 % of IA cases in children and adolescents with solid tumors. The additional risk factors were treatment in intensive care unit – 22.2 %, high-dose chemotherapy with autologous hematopoietic stem cell transplantation – 22.2 %, concomitant bacterial infection – 33.0 %. Surgical intervention for the underlying disease was performed in 77.7 % of patients. The most common clinical site of IA was the lungs – 88.9 %. The predominant clinical sign was fever – 66.7 %, cough and respiratory failure were seen less frequently – 33.4 % and33.4 %, respectively. The etiologicalagents of IA were Aspergillus fumigatus – 33.3 %, Aspergillus nidulans – 33.3 % and Aspergillus ustus – 33.3 %. 88.9 % of patients received antimycotic therapy, voriconazole predominantly – 66.7 %. Combination therapy was used in 33.3 % of patients. The overall 12-week survival in children and adolescents with IA in case of solid tumors was 77.8 %.

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“…-70 %. Вышеуказанную закономерность авторы связывают с внедрением методов ранней диагностики и началом использования вориконазола в качестве антифунгальной терапии [26].…”

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Invasive aspergillosis in children and adolescents with solid tumors: clinical cases and registry analysis

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Invasive candidiasis in children after hematopoietic stem cell transplantation

Markova

Rogacheva

Popova

et al. 2019

Voprosy gematologii/onkologii i immunopatologii v pediatrii

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Invasive fungal disease due to Candida spp. – Invasive candidiasis/candidaemia, is a life-threatening complication in immunosuppressed patients. The publications on epidemiology of invasive candidiasis (IC) in children after hematopoietic stem cell transplantation (HSCT) is limited. The purpose of the study was to study the epidemiology of IC in children after HSCT for the 7 years in Raisa Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation. In 2009–2016 yy have been performed 754 HSCT in children: 494 allogeneic and 260 autologous. The study was approved by the Independent Ethics Committee of the Raisa Gorbacheva Memorial Research Institute of Children's Oncology, Hematology and Transplantation. A retrospective study included 22 cases of invasive candidiasis in after HSCT. EORTC/MSG 2008 criteria were used for the diagnosis of proven invasive candidiasis as well as to evaluate response to therapy. Incidence of IC was 2.9%: allo-HSCT – 3% (n = 15), auto-HSCT – 2,7% (n = 7). The study was approved by the Independent Ethics Committee of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology. The etiology: Candida parapsilosis – 50%, Candida albicans – 27%, Candida krusei – 14%, Candida tropicalis – 5%, Candida dubliniensis – 4%. The most frequent underlying diseases was acute leukemia – 45% (n = 10). The median age was 8 y.o. (3 month–18 years). The median day of onset of IC after allo-HSCT was 63 days (4–243), auto-HSCT – 12 days (3–20). Febrile fever was the main clinical symptom; septic syndrome develops in 32% cases. Antifungal therapy was with echinocandins – 23%, lipid ampho B – 27%, triazole (fluconazole, voriconazole) – 32%, without therapy (due to early mortality) – 18%. Overall survival (OS) at 30 days from diagnosis invasive candidiasis was 50%. The central venous catheter (CVC) removal was the only factor significantly improved OS (70% vs 33%, p = 0,035). Incidence of Invasive candidiasis in children after hematopoietic stem cell transplantation was 2.9%. The main etiology agent was Candida parapsilosis. Invasive candidiasis infections most often affect leukemia patients, after allo-HSCT developed later than auto-HSCT. Overall survival at 30 days from the diagnosis was 50%. Removing of CVC improved overall survival in children with invasive candida infections after HSCT

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invasive aspergillosis in children in Saint-Petersburg

Abstract: О р и г и н а л ь н ы е и с с л е д о в а н и я

Cited by 2 publications

References 20 publications

Invasive aspergillosis in children and adolescents with solid tumors: clinical cases and registry analysis

Invasive aspergillosis in children and adolescents with solid tumors: clinical cases and registry analysis

Invasive candidiasis in children after hematopoietic stem cell transplantation

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