Chiusaroli Lorenzo, Cozzolino Claudia, Cocchio Silvia, Saia Mario, Giaquinto Carlo, Donà Daniele, Baldo Vincenzo
Division of Pediatric Infectious Diseases, Department for Women's and Children's Health, University of Padua, 35126 Padua, Italy.
Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35126 Padua, Italy.
Pathogens. 2025 Jan 18;14(1):93. doi: 10.3390/pathogens14010093.
Fungal infections (FIs) are widespread globally, affecting both immunocompromised and immunocompetent children, with varying clinical implications based on age and comorbidities. In immunocompromised children, particularly those with hematologic oncological conditions, FI leads to substantially longer hospital stays and increased in-hospital mortality, with reported rates ranging from 15% to 20%. Our study aims to analyze the epidemiological trends of fungal infections in the pediatric population within a specific region of Italy. We extracted ICD-9 codes related to fungal infections from hospital discharge records (HDRs) in the pediatric population of Veneto, located in the north-east of Italy, between 2007 and 2022. We included all children admitted to the hospital with a primary or secondary diagnosis during admission for other reasons. Data were stratified based on age, year, ward of admission, and type of diagnosis. Patients older than eighteen and HDRs related to a second admission within thirty days from the previous admission were excluded. A total of 1433 diagnoses were analyzed during the period, with 241 (16.8%) as main diagnoses and 1192 (83.2%) as secondary diagnoses. The overall hospitalization rate was 1084 cases/100,000 (1.69 cases/100,000 as primary diagnosis and 8.95 cases/100,000 as secondary). The hospitalization rate stratified for age was 11,055 cases/100,000 among infants younger than 1 year, 8.48 cases/100,000 among those aged 1-4 years, and 4.4 cases/100,000 among children older than 5. The more frequent infection was spp. (62.8%), followed by spp. (14.6%) and skin mycosis (9.5%). Overall, the pediatric in-hospital case fatality rate due to FI was 2.09%. Our study elucidated the overall experience of fungal infections in the pediatric population of the Veneto region in Italy. Specifically, we underscored a relatively stable hospitalization rate for fungal diseases and a noteworthy mortality rate.
真菌感染（FIs）在全球范围内广泛存在，影响免疫功能低下和免疫功能正常的儿童，根据年龄和合并症的不同具有不同的临床意义。在免疫功能低下的儿童中，尤其是患有血液肿瘤疾病的儿童，真菌感染会导致住院时间大幅延长和住院死亡率增加，报告的死亡率在15%至20%之间。我们的研究旨在分析意大利特定地区儿科人群中真菌感染的流行病学趋势。我们从意大利东北部威尼托地区儿科人群的医院出院记录（HDRs）中提取了与真菌感染相关的ICD - 9编码。我们纳入了所有因其他原因入院时具有原发性或继发性诊断的儿童。数据根据年龄、年份、入院科室和诊断类型进行分层。排除了18岁以上的患者以及与上次入院后30天内再次入院相关的HDRs。在此期间共分析了1433例诊断，其中241例（16.8%）为主要诊断，1192例（83.2%）为次要诊断。总体住院率为1084例/10万（原发性诊断为1.69例/10万，继发性诊断为8.95例/10万）。按年龄分层的住院率在1岁以下婴儿中为11055例/10万，1 - 4岁儿童中为8.48例/10万，5岁以上儿童中为4.4例/10万。最常见的感染是 菌属（62.8%），其次是 菌属（14.6%）和皮肤真菌病（9.5%）。总体而言，儿科患者因真菌感染的住院病死率为2.09%。我们的研究阐明了意大利威尼托地区儿科人群中真菌感染的总体情况。具体而言，我们强调了真菌疾病相对稳定的住院率和值得注意的死亡率。
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