CANDIDAEMIA SPECTRUM: RESULTS OF A THREE-YEAR ANALYSIS AT THE PEDIATRIC HAEMATOLOGY ONCOLOGY CENTRE, RUSSIA
(Abstract release date: 05/19/16)
EHA Library. Pirumova V. 06/09/16; 134792; PB1892
Dr. Valentina Pirumova
Contributions
Contributions
Abstract
Abstract: PB1892
Type: Publication Only
Background
Invasive infections due to Candida spp. are among the leading causes of morbidity and mortality of immunocompromised pediatric patients. Candidemia levels are still high, despite the ongoing improvements in diagnostics, prophylaxis and treatment possibilities. It not only affects the outcomes of cancer treatment, but also shifts the treatment costs. As for now, there are no data available on the epidemiology of invasive candida infections for pediatric hematology/oncology in Russia.
Aims
The study’s aim was to determine the rate and spectrum of candidemia in Russia’s largest pediatric hematology/oncology center.
Methods
We present a retrospective analysis of candidemias occurred at the Dmitry Rogachev Center for Pediatric Hematology, Oncology and Immunology, Moscow, Russia. All blood cultures positive for Candida spp. taken from 22 March 2013 to 22 November 2015 have been identified, and all first patient-episode pairs have been included. Spectrum of species, patient’s characteristics, treatment strategies and outcomes have been analyzed.
Results
During surveillance period 34 episodes in 32 patients occurred. 36 Candida spp. were identified. 2 patients had 2 separate candidemia episodes, and in 2 cases more than one Candida spp. was cultured. Age distribution was 0 – 21 years (58% 0-3 years, 16% 5 – 10 y., 26% 11 – 21 y.). The majority of patients had some sort of hematological malignancy (39%), 29% had primary immunodeficiency, 26% had solid tumors and 3% had severe congenital neutropenia. 6 patients among all those with candidemia were after hematopoietic stem cells transplantation (18.7%).C. parapsilosis was responsible for the majority of episodes (53%) (graph 1).In 11 of 18 isolates the ecchinocandines susceptibility testing was performed: 10 (90.9%) were susceptible, 1 had intermediate susceptibility.As the first line therapy, 19 patients (59%) received echinocandins, 6 — amphotericin B, 3 — voriconazole, and 3 — fluconazole. In all cases antifungals were given within 24 hours from the time of execution of the blood cultures. One patient did not receive any therapy (although the central line was removed immediately). Central line was removed in 29 (88%) cases.Speaking of the outcomes, 72% patients were alive at the end of the episode. Mortality attributed to Candidemia was 12.5% (4 cases), with the time median of 21 day (3 – 37 days).
Conclusion
Invasive candidiasis is a common complication in pediatric hematology/oncology patients. In our hospital in 2013–2015 candidemia accounted 8.6% of all bloodstream infections. C. parapsilosis was responsible for the majority of the cases, while mixed infections were rare. The attributive mortality was as high as 12.5%.
Session topic: E-poster
Keyword(s): Central venous catheter, Hematological malignancy, Infection, Pediatric
Type: Publication Only
Background
Invasive infections due to Candida spp. are among the leading causes of morbidity and mortality of immunocompromised pediatric patients. Candidemia levels are still high, despite the ongoing improvements in diagnostics, prophylaxis and treatment possibilities. It not only affects the outcomes of cancer treatment, but also shifts the treatment costs. As for now, there are no data available on the epidemiology of invasive candida infections for pediatric hematology/oncology in Russia.
Aims
The study’s aim was to determine the rate and spectrum of candidemia in Russia’s largest pediatric hematology/oncology center.
Methods
We present a retrospective analysis of candidemias occurred at the Dmitry Rogachev Center for Pediatric Hematology, Oncology and Immunology, Moscow, Russia. All blood cultures positive for Candida spp. taken from 22 March 2013 to 22 November 2015 have been identified, and all first patient-episode pairs have been included. Spectrum of species, patient’s characteristics, treatment strategies and outcomes have been analyzed.
Results
During surveillance period 34 episodes in 32 patients occurred. 36 Candida spp. were identified. 2 patients had 2 separate candidemia episodes, and in 2 cases more than one Candida spp. was cultured. Age distribution was 0 – 21 years (58% 0-3 years, 16% 5 – 10 y., 26% 11 – 21 y.). The majority of patients had some sort of hematological malignancy (39%), 29% had primary immunodeficiency, 26% had solid tumors and 3% had severe congenital neutropenia. 6 patients among all those with candidemia were after hematopoietic stem cells transplantation (18.7%).C. parapsilosis was responsible for the majority of episodes (53%) (graph 1).In 11 of 18 isolates the ecchinocandines susceptibility testing was performed: 10 (90.9%) were susceptible, 1 had intermediate susceptibility.As the first line therapy, 19 patients (59%) received echinocandins, 6 — amphotericin B, 3 — voriconazole, and 3 — fluconazole. In all cases antifungals were given within 24 hours from the time of execution of the blood cultures. One patient did not receive any therapy (although the central line was removed immediately). Central line was removed in 29 (88%) cases.Speaking of the outcomes, 72% patients were alive at the end of the episode. Mortality attributed to Candidemia was 12.5% (4 cases), with the time median of 21 day (3 – 37 days).
Conclusion
Invasive candidiasis is a common complication in pediatric hematology/oncology patients. In our hospital in 2013–2015 candidemia accounted 8.6% of all bloodstream infections. C. parapsilosis was responsible for the majority of the cases, while mixed infections were rare. The attributive mortality was as high as 12.5%.
Session topic: E-poster
Keyword(s): Central venous catheter, Hematological malignancy, Infection, Pediatric
Abstract: PB1892
Type: Publication Only
Background
Invasive infections due to Candida spp. are among the leading causes of morbidity and mortality of immunocompromised pediatric patients. Candidemia levels are still high, despite the ongoing improvements in diagnostics, prophylaxis and treatment possibilities. It not only affects the outcomes of cancer treatment, but also shifts the treatment costs. As for now, there are no data available on the epidemiology of invasive candida infections for pediatric hematology/oncology in Russia.
Aims
The study’s aim was to determine the rate and spectrum of candidemia in Russia’s largest pediatric hematology/oncology center.
Methods
We present a retrospective analysis of candidemias occurred at the Dmitry Rogachev Center for Pediatric Hematology, Oncology and Immunology, Moscow, Russia. All blood cultures positive for Candida spp. taken from 22 March 2013 to 22 November 2015 have been identified, and all first patient-episode pairs have been included. Spectrum of species, patient’s characteristics, treatment strategies and outcomes have been analyzed.
Results
During surveillance period 34 episodes in 32 patients occurred. 36 Candida spp. were identified. 2 patients had 2 separate candidemia episodes, and in 2 cases more than one Candida spp. was cultured. Age distribution was 0 – 21 years (58% 0-3 years, 16% 5 – 10 y., 26% 11 – 21 y.). The majority of patients had some sort of hematological malignancy (39%), 29% had primary immunodeficiency, 26% had solid tumors and 3% had severe congenital neutropenia. 6 patients among all those with candidemia were after hematopoietic stem cells transplantation (18.7%).C. parapsilosis was responsible for the majority of episodes (53%) (graph 1).In 11 of 18 isolates the ecchinocandines susceptibility testing was performed: 10 (90.9%) were susceptible, 1 had intermediate susceptibility.As the first line therapy, 19 patients (59%) received echinocandins, 6 — amphotericin B, 3 — voriconazole, and 3 — fluconazole. In all cases antifungals were given within 24 hours from the time of execution of the blood cultures. One patient did not receive any therapy (although the central line was removed immediately). Central line was removed in 29 (88%) cases.Speaking of the outcomes, 72% patients were alive at the end of the episode. Mortality attributed to Candidemia was 12.5% (4 cases), with the time median of 21 day (3 – 37 days).
Conclusion
Invasive candidiasis is a common complication in pediatric hematology/oncology patients. In our hospital in 2013–2015 candidemia accounted 8.6% of all bloodstream infections. C. parapsilosis was responsible for the majority of the cases, while mixed infections were rare. The attributive mortality was as high as 12.5%.
Session topic: E-poster
Keyword(s): Central venous catheter, Hematological malignancy, Infection, Pediatric
Type: Publication Only
Background
Invasive infections due to Candida spp. are among the leading causes of morbidity and mortality of immunocompromised pediatric patients. Candidemia levels are still high, despite the ongoing improvements in diagnostics, prophylaxis and treatment possibilities. It not only affects the outcomes of cancer treatment, but also shifts the treatment costs. As for now, there are no data available on the epidemiology of invasive candida infections for pediatric hematology/oncology in Russia.
Aims
The study’s aim was to determine the rate and spectrum of candidemia in Russia’s largest pediatric hematology/oncology center.
Methods
We present a retrospective analysis of candidemias occurred at the Dmitry Rogachev Center for Pediatric Hematology, Oncology and Immunology, Moscow, Russia. All blood cultures positive for Candida spp. taken from 22 March 2013 to 22 November 2015 have been identified, and all first patient-episode pairs have been included. Spectrum of species, patient’s characteristics, treatment strategies and outcomes have been analyzed.
Results
During surveillance period 34 episodes in 32 patients occurred. 36 Candida spp. were identified. 2 patients had 2 separate candidemia episodes, and in 2 cases more than one Candida spp. was cultured. Age distribution was 0 – 21 years (58% 0-3 years, 16% 5 – 10 y., 26% 11 – 21 y.). The majority of patients had some sort of hematological malignancy (39%), 29% had primary immunodeficiency, 26% had solid tumors and 3% had severe congenital neutropenia. 6 patients among all those with candidemia were after hematopoietic stem cells transplantation (18.7%).C. parapsilosis was responsible for the majority of episodes (53%) (graph 1).In 11 of 18 isolates the ecchinocandines susceptibility testing was performed: 10 (90.9%) were susceptible, 1 had intermediate susceptibility.As the first line therapy, 19 patients (59%) received echinocandins, 6 — amphotericin B, 3 — voriconazole, and 3 — fluconazole. In all cases antifungals were given within 24 hours from the time of execution of the blood cultures. One patient did not receive any therapy (although the central line was removed immediately). Central line was removed in 29 (88%) cases.Speaking of the outcomes, 72% patients were alive at the end of the episode. Mortality attributed to Candidemia was 12.5% (4 cases), with the time median of 21 day (3 – 37 days).
Conclusion
Invasive candidiasis is a common complication in pediatric hematology/oncology patients. In our hospital in 2013–2015 candidemia accounted 8.6% of all bloodstream infections. C. parapsilosis was responsible for the majority of the cases, while mixed infections were rare. The attributive mortality was as high as 12.5%.
Session topic: E-poster
Keyword(s): Central venous catheter, Hematological malignancy, Infection, Pediatric
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