Related Experiment Video
Updated: May 8, 2026
An Ex vivo Assay to Study Candida albicans Hyphal Morphogenesis in the Gastrointestinal Tract
Published on: July 1, 2020
[Invasive fungal infections in the pediatric intensive care unit: a clinical analysis of 38 cases]
Xiao-Fang Cai1, Ji-Min Sun, Zong-Qi Dong
1Department of Emergency, Wuhan Children's Hospital, Wuhan 430016, China. lwb717299@163.com.
Insights
Invasive fungal infections (IFI) in the pediatric intensive care unit (PICU) primarily affect the respiratory tract, with Candida albicans being the most common pathogen. Early diagnosis and antifungal treatment are crucial for improving outcomes in critically ill children.
Area of Science:
- Pediatric critical care medicine
- Infectious diseases
- Mycology
Context:
- Invasive fungal infections (IFI) pose a significant threat to critically ill children.
- Pediatric intensive care units (PICUs) are high-risk environments for IFI due to immunocompromised patients and invasive procedures.
Purpose:
- To characterize the clinical features, risk factors, and outcomes of IFI in a PICU setting.
- To establish a foundation for improved IFI prevention and treatment strategies in pediatric critical care.
Summary:
- A retrospective analysis of 38 pediatric patients with IFI in a PICU revealed pulmonary infections as the most common presentation (89%).
- Key risk factors included severe underlying conditions, broad-spectrum antibiotic use (95% carbapenem), systemic corticosteroids (47%), and invasive procedures (mechanical ventilation in 47%).
- Candida albicans (41%), Aspergilli (25%), and Mucor (20%) were the predominant fungal isolates. Despite non-specific symptoms, timely antifungal therapy resulted in an 82% response rate.
Impact:
- Highlights the respiratory tract as the primary site for IFI in PICU patients, with Candida albicans as the leading cause.
- Identifies critical risk factors, including broad-spectrum antibiotic and corticosteroid use, emphasizing the need for vigilant IFI surveillance.
- Underscores the importance of early diagnosis and prompt, effective antifungal treatment for favorable prognoses in pediatric IFI cases.
Objective:
To investigate the clinical features of invasive fungal infections (IFI) in the pediatric intensive care unit (PICU) and, to provide a basis for the effective prevention and treatment of IFI.
Methods:
Retrospective analysis was performed on the clinical features and treatment outcomes of 38 children with IFI who were admitted to the PICU of Wuhan Children's Hospital between January 2009 and August 2012.
Results:
Pulmonary fungal infection (89%) was the most common among the 38 cases. Before diagnosis of IFI, all patients had severe underlying diseases and received several broad-spectrum antibiotics, including carbapenems, which were used in 95% of cases; 47% of all cases had been treated with corticosteroids systemically; all patients had received invasive operations, and 47% of them had undergone endotracheal intubation and mechanical ventilation. None of these cases had either typical clinical symptoms and signs or specific imaging findings. Fifty-six strains of fungi were isolated, with Candida albicans (41%), Aspergilli (25%), and Mucor (20%) being the most common ones. All patients received timely antifungal therapies, 15 cases were cured and 16 cases showed improvements, with a response rate of 82%, and the rate of adverse events was 16%.
Conclusions:
In the PICU, the respiratory tract is the most common site of IFI infection, and Candida albicans is the leading pathogen. Severe underlying diseases, use of broad-spectrum antibiotics and corticosteroids, and invasive operations are the main risk factors for IFI in the PICU. Early diagnosis and timely treatment with high-performance antifungal drugs can improve the prognosis in children with IFI.
Related Concept Videos
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies. Common...
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
01:30Pneumonia III: Complications and Assessment
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin create...