title: Prospective study on fungemia in children with cancer: analysis of 35 cases and comparison with 130 fungemias in adults.
abstract: The aim of this prospective study on fungemia in children with cancer compared with adults with cancer appearing during the last 10 years in a pediatric hospital and in national cancer institutions was to investigate risk factors, etiology, therapy, complications and outcome. Univariate analysis showed significant differences in 35 children with cancer and fungemia in comparison with 130 cases of fungemias in adults with cancer. It was found that (1) therapy with corticosteroids (40 vs 18.5%, P<0.03), (2) breakthrough fungemia during ketoconazole prophylaxis (20 vs 7.7%, P<0.025), and (3) meningitis as a complication of fungemia (11.4 vs 0.8%, P< 0.001) occurred more frequently in the pediatric subgroup with fungemia. Candida albicans was more common as the causative agent of fungemia among adults (58.5 vs 37.1, P<0.02) than in children. However, mortality was similar in children with cancer and in adults with cancer and fungemia (31.4 vs 23.1%, NS). Comparison of risk factors revealed no differences between adults and children with cancer and fungemia except in etiology, breakthrough fungemia during prophylaxis with ketoconazole, prior therapy with corticosteroids and meningitis as a complication. The outcome was also similar in pediatric and adult cancer patients with fungal bloodstream infection.
authors.affiliation: St. Elizabeth and National Cancer Institute, Bratislava, Slovak Republic.
authors.forename: Y
authors.initials: Y
authors.lastname: Krupova
authors.forename: D
authors.initials: D
authors.lastname: Sejnova
authors.forename: J
authors.initials: J
authors.lastname: Dzatkova
authors.forename: E
authors.initials: E
authors.lastname: Kaiserova
authors.forename: M
authors.initials: M
authors.lastname: Kiskova
authors.forename: R
authors.initials: R
authors.lastname: Babela
authors.forename: F
authors.initials: F
authors.lastname: Mateicka
authors.forename: A
authors.initials: A
authors.lastname: Sabo
authors.forename: E
authors.initials: E
authors.lastname: Pichnova
authors.forename: L
authors.initials: L
authors.lastname: Jurga
authors.forename: M
authors.initials: M
authors.lastname: Sulcova
authors.forename: V
authors.initials: V
authors.lastname: Krcmery
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use*; D002176:Candida albicans / Q000302:isolation & purification / Q000472:pathogenicity; D002177:Candidiasis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D016469:Fungemia / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D007654:Ketoconazole / Q000627:therapeutic use; D008297:Male; D008581:Meningitis / Q000209:etiology / Q000382:microbiology; D009369:Neoplasms / Q000150:complications* / Q000382:microbiology; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000935:Antifungal Agents; D007654:Ketoconazole