[Invasive fungal infections in children with cancer, neutropenia and fever, in Chile].
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.
Lucero
Yalda
Y
Programa de Microbiología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile.
Brücher
Roberto
R
Alvarez
Ana María
AM
Becker
Ana
A
Cofré
José
J
Enríquez
Nancy
N
Payá
Ernesto
E
Salgado
Carmen
C
Santolaya
María Elena
ME
Tordecilla
Juan
J
Varas
Mónica
M
Villarroel
Milena
M
Viviani
Tamara
T
Zubieta
Marcela
M
O'Ryan
Miguel
M
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