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Invasive fungal disease in PICU: epidemiology and risk factors

Olivier Brissaud1, Julie Guichoux, Jerome Harambat

  • 1Pediatric and Neonatal Intensive Care Unit, The Children's' Hospital of Bordeaux, Place Amélie Raba Léon, 33076 Bordeaux Cedex, France. Olivier.brissaud@chu-bordeaux.fr.

Annals of Intensive Care
|February 24, 2012
PubMed

Insights

Invasive fungal infections in children, primarily from Candida and Aspergillus, are increasing. Invasive candidiasis is more common than aspergillosis, but aspergillosis carries a higher mortality rate.

Area of Science:

  • Pediatric Infectious Diseases
  • Mycology
  • Critical Care Medicine

Background:

  • Invasive fungal infections (IFIs) in children pose significant mortality, morbidity, and healthcare burdens.
  • The incidence of IFIs caused by Candida and Aspergillus species has notably increased over the last two decades.
  • Invasive candidiasis is more prevalent in children than invasive aspergillosis, yet both are critical concerns.

Purpose of the Study:

  • To review the epidemiology and risk factors of invasive candidiasis and invasive aspergillosis in pediatric populations.
  • To highlight the differential characteristics and outcomes of these infections in various pediatric subgroups.
  • To underscore the importance of understanding IFI trends in children.

Main Methods:

  • Literature review and synthesis of epidemiological data on pediatric IFIs.
  • Analysis of incidence, causative agents, and associated risk factors.
  • Comparison of mortality rates between invasive candidiasis and invasive aspergillosis in children.

Main Results:

  • Candida and Aspergillus species are the leading causes of IFIs in children, with increasing incidence.
  • Invasive candidiasis is five times more common than invasive aspergillosis in pediatric patients.
  • Candida albicans is the predominant species, but non-albicans Candida emergence is noted.
  • Invasive aspergillosis is more frequently linked to hematological malignancies and solid tumors.
  • Mortality rates for invasive aspergillosis (70%) are substantially higher than for invasive candidiasis (20-30%) in children.

Conclusions:

  • Epidemiology and risk factors for IFIs vary significantly between previously healthy children in the ICU and those with malignancies or severe hematological diseases.
  • Despite lower incidence, invasive aspergillosis presents a more severe threat with higher mortality in pediatric populations.
  • Continued surveillance and understanding of IFI trends are crucial for effective management and improved outcomes in children.

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