Invasive Fungal Infections in Children with Acute Leukemia: Epidemiology, Risk Factors, and Outcome
Invasive fungal infections (IFI) cause morbidity and mortality in children with acute leukemia (AL). We retrospectively collected data on febrile neutropenic episodes (FNE) in AL children (2016–2021) and assessed factors associated with proven/probable IFI. Ninety-three children developed 339 FNE. S...
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MDPI AG
2024-01-01
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| Series: | Microorganisms |
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| Online Access: | https://www.mdpi.com/2076-2607/12/1/145 |
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| author | Tamar Ruth Gal Etzioni Nurit Fainshtain Adi Nitzan-Luques Gal Goldstein Sigal Weinreb Violeta Temper Maya Korem Dina Averbuch |
| author_facet | Tamar Ruth Gal Etzioni Nurit Fainshtain Adi Nitzan-Luques Gal Goldstein Sigal Weinreb Violeta Temper Maya Korem Dina Averbuch |
| author_sort | Tamar Ruth Gal Etzioni |
| collection | DOAJ |
| description | Invasive fungal infections (IFI) cause morbidity and mortality in children with acute leukemia (AL). We retrospectively collected data on febrile neutropenic episodes (FNE) in AL children (2016–2021) and assessed factors associated with proven/probable IFI. Ninety-three children developed 339 FNE. Seventeen (18.3%) children developed 19 proven/probable IFI (11 yeast; eight molds). The proven/probable yeast IFI rate was 6/52 (11.5%) in children who belong to the high risk for IFI category (HR-IFI-AL: high-risk acute lymphocytic leukemia (ALL), acute myeloid leukemia, relapse); and 5/41 (12.2%) in the non-HR-IFI-AL category (standard/intermediate risk ALL). The proven/probable mold IFI rate was 7/52 (13.5%) in HR-IFI-AL children and 1/41 (2.4%) in the non-HR-IFI-AL category. In the multivariable analysis, underlying genetic syndrome, oral mucositis, and older age were significantly associated with proven/probable IFI, while a longer time since AL diagnosis was protective. Two of 13 (15.4%) HR-IFI-AL children died because of IFI. The elevated risks of proven/probable mold IFI and the associated mortality in HR-IFI-AL children, and high risk of invasive candidiasis in the non-HR-IFI-AL group, emphasize the need for the close monitoring of local epidemiology and the adjustment of practices accordingly. |
| first_indexed | 2024-03-08T09:50:17Z |
| format | Article |
| id | doaj.art-e2648022573049f68e48a4bc122e3c98 |
| institution | Directory Open Access Journal |
| issn | 2076-2607 |
| language | English |
| last_indexed | 2024-03-08T09:50:17Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Microorganisms |
| spelling | doaj.art-e2648022573049f68e48a4bc122e3c982024-01-29T14:06:35ZengMDPI AGMicroorganisms2076-26072024-01-0112114510.3390/microorganisms12010145Invasive Fungal Infections in Children with Acute Leukemia: Epidemiology, Risk Factors, and OutcomeTamar Ruth Gal Etzioni0Nurit Fainshtain1Adi Nitzan-Luques2Gal Goldstein3Sigal Weinreb4Violeta Temper5Maya Korem6Dina Averbuch7Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, IsraelFaculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, IsraelFaculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, IsraelFaculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, IsraelFaculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, IsraelFaculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, IsraelFaculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, IsraelFaculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91120, IsraelInvasive fungal infections (IFI) cause morbidity and mortality in children with acute leukemia (AL). We retrospectively collected data on febrile neutropenic episodes (FNE) in AL children (2016–2021) and assessed factors associated with proven/probable IFI. Ninety-three children developed 339 FNE. Seventeen (18.3%) children developed 19 proven/probable IFI (11 yeast; eight molds). The proven/probable yeast IFI rate was 6/52 (11.5%) in children who belong to the high risk for IFI category (HR-IFI-AL: high-risk acute lymphocytic leukemia (ALL), acute myeloid leukemia, relapse); and 5/41 (12.2%) in the non-HR-IFI-AL category (standard/intermediate risk ALL). The proven/probable mold IFI rate was 7/52 (13.5%) in HR-IFI-AL children and 1/41 (2.4%) in the non-HR-IFI-AL category. In the multivariable analysis, underlying genetic syndrome, oral mucositis, and older age were significantly associated with proven/probable IFI, while a longer time since AL diagnosis was protective. Two of 13 (15.4%) HR-IFI-AL children died because of IFI. The elevated risks of proven/probable mold IFI and the associated mortality in HR-IFI-AL children, and high risk of invasive candidiasis in the non-HR-IFI-AL group, emphasize the need for the close monitoring of local epidemiology and the adjustment of practices accordingly.https://www.mdpi.com/2076-2607/12/1/145invasive fungal infectionsacute leukemiachildrenrisk factors |
| spellingShingle | Tamar Ruth Gal Etzioni Nurit Fainshtain Adi Nitzan-Luques Gal Goldstein Sigal Weinreb Violeta Temper Maya Korem Dina Averbuch Invasive Fungal Infections in Children with Acute Leukemia: Epidemiology, Risk Factors, and Outcome Microorganisms invasive fungal infections acute leukemia children risk factors |
| title | Invasive Fungal Infections in Children with Acute Leukemia: Epidemiology, Risk Factors, and Outcome |
| title_full | Invasive Fungal Infections in Children with Acute Leukemia: Epidemiology, Risk Factors, and Outcome |
| title_fullStr | Invasive Fungal Infections in Children with Acute Leukemia: Epidemiology, Risk Factors, and Outcome |
| title_full_unstemmed | Invasive Fungal Infections in Children with Acute Leukemia: Epidemiology, Risk Factors, and Outcome |
| title_short | Invasive Fungal Infections in Children with Acute Leukemia: Epidemiology, Risk Factors, and Outcome |
| title_sort | invasive fungal infections in children with acute leukemia epidemiology risk factors and outcome |
| topic | invasive fungal infections acute leukemia children risk factors |
| url | https://www.mdpi.com/2076-2607/12/1/145 |
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