title: An update on pediatric invasive aspergillosis.
abstract: Invasive aspergillosis (IA) is a major cause of morbidity and mortality in immunocompromised adults and children, the number of which has been continuously increasing in the last decades. The purpose of our review was to provide epidemiological, clinical, and biological data and antifungal treatment options in the pediatric population. Several biological assays (galactomannan enzyme immunoassay, β-D-glucan, detection of Aspergillus spp. DNA) have proven useful adjuncts for the diagnosis of IA in adult studies. However, data on these assays in children is limited by small sample sizes and sometimes conflicting results concerning their sensitivity/specificity. Pediatric treatment recommendations are mainly extrapolated from results of clinical trials performed in adults. It is thus necessary to develop new antifungal formulations specifically adapted to the pediatric population and to evaluate their pharmacokinetic/pharmacodynamic profile, their safety, and their effectiveness in infants and children.
authors.affiliation: Laboratoire de microbiologie clinique, hôpital Necker-Enfants-Malades, Assistance publique-Hôpitaux de Paris (AP-HP), 149, rue de Sèvres, 75015 Paris, France; Unité d'immunologie, hématologie et rhumatologie pédiatriques, hôpital Necker-Enfants-Malades, AP-HP, 75015 Paris, France; EA 7327, université Paris Descartes, Sorbonne-Paris-Cité, 75015 Paris, France. Electronic address: pierre.frange@nck.aphp.fr.
authors.forename: P
authors.initials: P
authors.lastname: Frange
authors.affiliation: Laboratoire de microbiologie clinique, hôpital Necker-Enfants-Malades, Assistance publique-Hôpitaux de Paris (AP-HP), 149, rue de Sèvres, 75015 Paris, France; Unité biologie et pathogénicité fongiques, Institut Pasteur, Inra USC2019, 75015 Paris, France.
authors.forename: M-E
authors.initials: ME
authors.lastname: Bougnoux
authors.affiliation: Service de maladies infectieuses et tropicales, centre d'infectiologie Necker-Pasteur, hôpital Necker-Enfants-Malades, AP-HP, 75015 Paris, France; Université Paris Descartes, institut Imagine, Sorbonne-Paris-Cité, 75015 Paris, France; Inserm UMR1163, laboratoire de génétique humaine des maladies infectieuses, site Necker, université Paris Descartes, institut Imagine, Sorbonne-Paris-Cité, 75015 Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Lanternier
authors.affiliation: Unité d'immunologie, hématologie et rhumatologie pédiatriques, hôpital Necker-Enfants-Malades, AP-HP, 75015 Paris, France; Université Paris Descartes, institut Imagine, Sorbonne-Paris-Cité, 75015 Paris, France; Inserm UMR 1163, laboratoire d'immunogénétique de l'auto-immunité pédiatrique, 75015 Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Neven
authors.affiliation: Unité d'immunologie, hématologie et rhumatologie pédiatriques, hôpital Necker-Enfants-Malades, AP-HP, 75015 Paris, France; Université Paris Descartes, institut Imagine, Sorbonne-Paris-Cité, 75015 Paris, France; Inserm UMR1163, dynamique du génome et système immunitaire, 75015 Paris, France.
authors.forename: D
authors.initials: D
authors.lastname: Moshous
authors.affiliation: Laboratoire de microbiologie clinique, hôpital Necker-Enfants-Malades, Assistance publique-Hôpitaux de Paris (AP-HP), 149, rue de Sèvres, 75015 Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Angebault
authors.affiliation: Unité biologie et pathogénicité fongiques, Institut Pasteur, Inra USC2019, 75015 Paris, France; Service de maladies infectieuses et tropicales, centre d'infectiologie Necker-Pasteur, hôpital Necker-Enfants-Malades, AP-HP, 75015 Paris, France; Université Paris Descartes, institut Imagine, Sorbonne-Paris-Cité, 75015 Paris, France.
authors.forename: O
authors.initials: O
authors.lastname: Lortholary
authors.affiliation: Unité d'immunologie, hématologie et rhumatologie pédiatriques, hôpital Necker-Enfants-Malades, AP-HP, 75015 Paris, France; Université Paris Descartes, institut Imagine, Sorbonne-Paris-Cité, 75015 Paris, France; EA08, université Paris Descartes, Sorbonne-Paris-Cité, 75015 Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Blanche
mesh_terms: D000293:Adolescent; D000935:Antifungal Agents / Q000627:therapeutic use; D000946:Antigens, Fungal / Q000097:blood; D000970:Antineoplastic Agents / Q000009:adverse effects; D001228:Aspergillosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D001230:Aspergillus / Q000187:drug effects / Q000276:immunology / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D004271:DNA, Fungal / Q000097:blood; D016469:Fungemia / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007223:Infant; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy; D011183:Postoperative Complications / Q000188:drug therapy / Q000382:microbiology; D017410:Practice Guidelines as Topic; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors
chemical_list: D000935:Antifungal Agents; D000946:Antigens, Fungal; D000970:Antineoplastic Agents; D004271:DNA, Fungal; D007166:Immunosuppressive Agents
keywords: Antifungal therapy; Aspergilloses invasives; Invasive aspergillosis; Pediatrics; Pédiatrie; Traitement antifongique