Invasive Candidiasis in Infants and Children: Recent Advances in Epidemiology, Diagnosis, and Treatment

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Thomas J Walsh1, Aspasia Katragkou2, Tempe Chen3

  • 1Departments of Medicine, Pediatrics, and Microbiology & immunology, Weill Cornell Medicine of Cornell University and New York Presbyterian Hospital, New York, NY 10065, USA. thw2003@med.cornell.edu.

Journal of Fungi (Basel, Switzerland)
|January 26, 2019
PubMed

Insights

Pediatric invasive candidiasis is declining but remains serious. Advances in rapid diagnostics like T2Candida and biomarkers such as (1→3)-β-d-glucan improve early detection and treatment of this critical fungal infection in children.

Area of Science:

  • Pediatric Infectious Diseases
  • Mycology
  • Clinical Microbiology

Background:

  • Pediatric invasive candidiasis presents significant mortality and morbidity.
  • Despite declining incidence, clinical suspicion remains crucial.
  • Effective management requires rapid diagnostics and prompt antifungal therapy.

Purpose of the Study:

  • To review recent advances in pediatric invasive candidiasis.
  • Focus areas include epidemiology, diagnosis, and treatment.
  • Highlight novel diagnostic tools and therapeutic options.

Main Methods:

  • Review of current literature on pediatric invasive candidiasis.
  • Analysis of epidemiological trends and clinical outcomes.
  • Evaluation of emerging diagnostic technologies and antifungal treatments.

Main Results:

  • Epidemiological trends show a decrease in pediatric invasive candidiasis incidence.
  • Non-culture-based diagnostics (T2Candida, (1→3)-β-d-glucan) show promise for early detection.
  • (1→3)-β-d-glucan in CSF is a key indicator for hematogenous disseminated Candida meningoencephalitis (HCME).
  • Pharmacokinetic data for liposomal amphotericin B in children are comparable to adults.
  • Clinical trials provide safety data for micafungin in neonatal candidemia.

Conclusions:

  • Early detection and treatment are vital for improving outcomes in pediatric invasive candidiasis.
  • Novel diagnostic methods enhance the ability to identify candidemia and CNS candidiasis.
  • Established and emerging antifungal therapies demonstrate efficacy and safety in pediatric populations.
Keywords:
(1→3)-β-d-glucanCandida meningoencephalitisPCRT2Candidaanidulafungincandidemialiposomal amphotericin Bmicafungin

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