title: [Invasive fungal infections in children with cancer, neutropenia and fever, in Chile].
abstract: BACKGROUND
  Invasive fungal infections (IFI) cause prolonged hospitalizations and increase the possibility of death among patients with cancer and febrile neutropenia (FN). Up to 10% of febrile neutropenic episodes may be caused by IFI.
  
  
  OBJECTIVE
  To estimate the incidence of IFI among a large group of Chilean children with cancer and FN.
  
  
  METHODS
  Clinical and laboratory information was collected from a data base provided by the "Programa Infantil Nacional de Drogas Antineoplásicas" (PINDA) that included 445 FN episodes occurring in five hospitals in Santiago, Chile. This information was used to identify children that presented with signs and symptoms compatible with an IFI. According to predefined criteria based on a literature review, IFI episodes were categorized as "proven", "probable" or "possible".
  
  
  RESULTS
  A total of 41/445 episodes (9.2%) were compatible with an IFI of which 4 (0.9%) were proven, 23 (5.2%) probable, and 14 (3.1%) possible. Hospitalization was longer (27 vs 8 days, p < .01), new infectious foci appeared with higher frequency (71 vs 38%, p < .01), and mortality was higher (10 vs 1.6%, p < .001) in children with IFI compatible episodes, when compared to children who did not have an IFI.
  
  
  CONCLUSIONS
  The estimated incidence of IFI in Chilean children with cancer and FN ranged between 6-9% depending on the stringency of criteria selection used for classification. This estimate is similar to that reported by other studies. The low detection yield of clinically compatible IFI underscores the need of improved diagnosis of fungal infections in this population.
authors.affiliation: Programa de Microbiología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile.
authors.forename: Yalda
authors.initials: Y
authors.lastname: Lucero
authors.forename: Roberto
authors.initials: R
authors.lastname: Brücher
authors.forename: Ana María
authors.initials: AM
authors.lastname: Alvarez
authors.forename: Ana
authors.initials: A
authors.lastname: Becker
authors.forename: José
authors.initials: J
authors.lastname: Cofré
authors.forename: Nancy
authors.initials: N
authors.lastname: Enríquez
authors.forename: Ernesto
authors.initials: E
authors.lastname: Payá
authors.forename: Carmen
authors.initials: C
authors.lastname: Salgado
authors.forename: María Elena
authors.initials: ME
authors.lastname: Santolaya
authors.forename: Juan
authors.initials: J
authors.lastname: Tordecilla
authors.forename: Mónica
authors.initials: M
authors.lastname: Varas
authors.forename: Milena
authors.initials: M
authors.lastname: Villarroel
authors.forename: Tamara
authors.initials: T
authors.lastname: Viviani
authors.forename: Marcela
authors.initials: M
authors.lastname: Zubieta
authors.forename: Miguel
authors.initials: M
authors.lastname: O'Ryan
mesh_terms: D000293:Adolescent; D002648:Child; D002677:Chile / Q000453:epidemiology; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D015994:Incidence; D008297:Male; D009181:Mycoses / Q000453:epidemiology* / Q000209:etiology; D009369:Neoplasms / Q000150:complications*; D009503:Neutropenia / Q000150:complications*; D012720:Severity of Illness Index