Ansari Sh, Shirzadi E, Elahi M
Assistant professor of Pediatrician, Oncologist, Ali-Asghar Children Hospital, Iran University of Medical Sciences, Tehran, Iran.
General practitioner, Ali-Asghar Children Hospital, Iran University of Medical Sciences, Tehran, Iran.
Iran J Ped Hematol Oncol. 2015;5(1):1-10. Epub 2015 Mar 15.
A fungal infection represents a growing problem in children with hematologic malignancies, during chemotherapy induced neutropenia. Fungal colonization is considered a major risk factor for subsequent fungal infections. The aim of this retrospective study was to evaluate prevalence of fungal infection among children admitted to hospital between 2005 and 2010 in Tehran, Iran.
617 hematological patients in the age range of neoteric to 19 years old were enrolled and 87 cases with invasive fungal infections were extracted from patients' files and documented. Diagnosis of fungal infections was based on the local biopsy and pathology for mucormycosis, blood culture, urine culture and clinical examination for candidasis and galactomannan for aspergillus.
the mean age of cancer diagnosis was 6.33 years old and the mean age of fungal infection was 7.95 years old. The majority of the infections was caused by candidia spp (74.7%), followed by aspergillus spp (17.2%) and zygomycetes (11.5%). Among candidiasis patients, oral infection had the highest manifestation (92.3%) whereas in 10 of 15 patients with aspergillus, the infectious site was the lung. There was a significant association between mortality and the type of fungal infection (p <0.0001).
Our finding suggests that there is a high rate of fungal infections in children receiving remission therapy for onco-hematology. These results help improve the management of these patients, however Further studies are needed.
真菌感染是血液系统恶性肿瘤患儿在化疗引起的中性粒细胞减少期间日益严重的问题。真菌定植被认为是随后真菌感染的主要危险因素。这项回顾性研究的目的是评估2005年至2010年期间伊朗德黑兰住院儿童中真菌感染的患病率。
纳入617例年龄在新生儿至19岁之间的血液学患者,并从患者病历中提取87例侵袭性真菌感染病例并记录在案。真菌感染的诊断基于毛霉菌病的局部活检和病理学、血培养、尿培养以及念珠菌病的临床检查和曲霉菌的半乳甘露聚糖检测。
癌症诊断的平均年龄为6.33岁,真菌感染的平均年龄为7.95岁。大多数感染由念珠菌属引起(74.7%),其次是曲霉菌属(17.2%)和接合菌(11.5%)。在念珠菌病患者中,口腔感染表现最为常见(92.3%),而在15例曲霉菌感染患者中有10例感染部位是肺部。死亡率与真菌感染类型之间存在显著关联(p<0.0001)。
我们的研究结果表明,接受肿瘤血液学缓解治疗的儿童中真菌感染率很高。这些结果有助于改善对这些患者的管理,然而还需要进一步的研究。