The fungal DNA examination is useful as a sensitive parameter for the initiation and the quit of antifungal therapy in immunocompromised pediatric patients after surgery.
The purpose of this study is whether the fungal deoxyribonucleic acid (DNA) examination is useful as a sensitive parameter for pediatric surgical patients with mycosis. The eleven episodes of five cases (4 cases; progressive liver disease after biliary atresia operation, 1 case; short bowel syndrome and long term total parenteral nutrition with megacystis microcolon intestinal hypoperistalsis syndrome) with mycosis were divided into two groups according to the difference of therapeutic protocols. The sensitivity of fungal DNA examination, serum Candida antigen level, plasma beta-D glucan level, and blood culture were evaluated at the onset of infection and at the quit of antifungal medication under the protocols respectively. The duration of medication and the medication free interval in two groups were compared. The 6 episodes (3 cases) were diagnosed and treated under the protocol not including fungal DNA examination, while the 5 episodes (2 cases) under the protocol including fungal DNA examination. The occurrence rate was not significant. The sensitivity of fungal DNA examination was complete, but others were not. Using the fungal DNA examination, the duration of medication became significantly short. We conclude that the fungal DNA examination could be a sensitive parameter not only to start but to quit antifungal medication in pediatric patients with mycosis.
Hikida
Shigeki
S
Departments of Pediatric Surgery, Kurume University School of Medicine, Kurume 830-0011, Japan. shikida@med.kurume-u.ac.jp
Tanaka
Yoshiaki
Y
Tsuru
Tomomitsu
T
Ohtani
Mari
M
Kobayashi
Hidefumi
H
Asagiri
Kimio
K
Akiyoshi
Kenjirou
K
Nakamizo
Hirotaka
H
Fukahori
Suguru
S
Soejima
Hiroko
H
Shirouzu
Yasumasa
Y
Tanigawa
Hirokazu
H
Shirouzu
Kazuo
K
Mizote
Hiroyoshi
H
D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001232:Aspergillus fumigatus / Q000235:genetics; D002176:Candida albicans / Q000235:genetics; D002648:Child; D004271:DNA, Fungal / Q000032:analysis*; D006801:Humans; D016867:Immunocompromised Host; D009181:Mycoses / Q000188:drug therapy* / Q000382:microbiology; D045363:Pneumocystis carinii / Q000235:genetics; D011183:Postoperative Complications; D012680:Sensitivity and Specificity
D000935:Antifungal Agents; D004271:DNA, Fungal