Epidemic outbreak of candidemia caused by unusual types of Candida non-albicans: clinical course patterns and search for the source

Introduction: Invasive fungal infections (IFI) remain an unresolved issue of hematology/oncology despite the introduction of methods of early diagnostic and invent of new highly active antimycotics. In etiologic structure of IFI the leading role belongs to candidiasis, the most frequent clinical for...

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Main Authors: I. I. Kalinina, D. V. Litvinov, I. V. Veselova, N. I. Ponomareva, L. N. Shelikhova, V. V. Fominykh, G. A. Klyasova, A. A. Maschan
Format: Article
Language:Russian
Published: ABV-press 2014-07-01
Series:Онкогематология
Subjects:
Online Access:https://oncohematology.abvpress.ru/ongm/article/view/104
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author I. I. Kalinina
D. V. Litvinov
I. V. Veselova
N. I. Ponomareva
L. N. Shelikhova
V. V. Fominykh
G. A. Klyasova
A. A. Maschan
author_facet I. I. Kalinina
D. V. Litvinov
I. V. Veselova
N. I. Ponomareva
L. N. Shelikhova
V. V. Fominykh
G. A. Klyasova
A. A. Maschan
author_sort I. I. Kalinina
collection DOAJ
description Introduction: Invasive fungal infections (IFI) remain an unresolved issue of hematology/oncology despite the introduction of methods of early diagnostic and invent of new highly active antimycotics. In etiologic structure of IFI the leading role belongs to candidiasis, the most frequent clinical form of which is candidemia. Candidemias in the pediatric hematology/oncology departments usually occur as sporadic cases, and epidemics are very rare. We describe an epidemic outbreak of candidemia caused by species of Candida non-albicans rarely reported in patients.Results: Ten cases of candidemia were registered in the hematology/oncology department within one month. Candidemia was caused by C. guilliermondi in 4 patients (in 1 concomitantly with C. calliculosa), by С. parapsilosis – in 3 patients and by C. pelliculosa in another 3 patients. Contaminated intravenous 4 % KCl solution has been found to be the source of candidemia. In four patients granulocytes count was < 0.5  109/l at the time of positive blood cultures. Clinical manifestation of candidemia included fever > 38.5 in all patients and lung involvement in 2 patients. All patients received systemic antifungal therapy: 5 — monotherapy, 3 — combinations of 2 drugs and 2 — of 3 drugs. Central venous catheter was removed in 4 patients. Clinical and microbiological cure was achieved in all patients; the mortality rate was 0 %. In 2 patients candidemia relapsed 22 and 60 days after the first episode.Conclusions: Outbreaks of systemic infections caused by unusual pathogens necessitate searching of a single infection source. Candidemia caused by a direct pathogen inoculation in the bloodstream, in the absence of multiple risk factors for invasive fungal infections follows a favorable course.
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spelling doaj.art-a2a1f518637c4876adf910028138d37c2025-03-02T13:07:09ZrusABV-pressОнкогематология1818-83462413-40232014-07-0161394410.17650/1818-8346-2011-6-1-39-44119Epidemic outbreak of candidemia caused by unusual types of Candida non-albicans: clinical course patterns and search for the sourceI. I. Kalinina0D. V. Litvinov1I. V. Veselova2N. I. Ponomareva3L. N. Shelikhova4V. V. Fominykh5G. A. Klyasova6A. A. Maschan7Federal Research Center of Pediatric Hematology, Oncology and ImmunologyRussian Children Clinical HospitalRussian Children Clinical HospitalRussian Children Clinical HospitalFederal Research Center of Pediatric Hematology, Oncology and Immunology Russian Children Clinical HospitalRussian Children Clinical HospitalHematological Research CenterFederal Research Center of Pediatric Hematology, Oncology and ImmunologyIntroduction: Invasive fungal infections (IFI) remain an unresolved issue of hematology/oncology despite the introduction of methods of early diagnostic and invent of new highly active antimycotics. In etiologic structure of IFI the leading role belongs to candidiasis, the most frequent clinical form of which is candidemia. Candidemias in the pediatric hematology/oncology departments usually occur as sporadic cases, and epidemics are very rare. We describe an epidemic outbreak of candidemia caused by species of Candida non-albicans rarely reported in patients.Results: Ten cases of candidemia were registered in the hematology/oncology department within one month. Candidemia was caused by C. guilliermondi in 4 patients (in 1 concomitantly with C. calliculosa), by С. parapsilosis – in 3 patients and by C. pelliculosa in another 3 patients. Contaminated intravenous 4 % KCl solution has been found to be the source of candidemia. In four patients granulocytes count was < 0.5  109/l at the time of positive blood cultures. Clinical manifestation of candidemia included fever > 38.5 in all patients and lung involvement in 2 patients. All patients received systemic antifungal therapy: 5 — monotherapy, 3 — combinations of 2 drugs and 2 — of 3 drugs. Central venous catheter was removed in 4 patients. Clinical and microbiological cure was achieved in all patients; the mortality rate was 0 %. In 2 patients candidemia relapsed 22 and 60 days after the first episode.Conclusions: Outbreaks of systemic infections caused by unusual pathogens necessitate searching of a single infection source. Candidemia caused by a direct pathogen inoculation in the bloodstream, in the absence of multiple risk factors for invasive fungal infections follows a favorable course.https://oncohematology.abvpress.ru/ongm/article/view/104candidemiacandida non-albicanschildrenepidemichematology/oncology
spellingShingle I. I. Kalinina
D. V. Litvinov
I. V. Veselova
N. I. Ponomareva
L. N. Shelikhova
V. V. Fominykh
G. A. Klyasova
A. A. Maschan
Epidemic outbreak of candidemia caused by unusual types of Candida non-albicans: clinical course patterns and search for the source
Онкогематология
candidemia
candida non-albicans
children
epidemic
hematology/oncology
title Epidemic outbreak of candidemia caused by unusual types of Candida non-albicans: clinical course patterns and search for the source
title_full Epidemic outbreak of candidemia caused by unusual types of Candida non-albicans: clinical course patterns and search for the source
title_fullStr Epidemic outbreak of candidemia caused by unusual types of Candida non-albicans: clinical course patterns and search for the source
title_full_unstemmed Epidemic outbreak of candidemia caused by unusual types of Candida non-albicans: clinical course patterns and search for the source
title_short Epidemic outbreak of candidemia caused by unusual types of Candida non-albicans: clinical course patterns and search for the source
title_sort epidemic outbreak of candidemia caused by unusual types of candida non albicans clinical course patterns and search for the source
topic candidemia
candida non-albicans
children
epidemic
hematology/oncology
url https://oncohematology.abvpress.ru/ongm/article/view/104
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