Results from a prospective, international, epidemiologic study of invasive candidiasis in children and neonates

William J. Steinbach, Emmanuel Roilides, David Berman, Jill A. Hoffman, Andreas H. Groll, Ibrahim Bin-Hussain, Debra L. Palazzi, Elio Castagnola, Natasha Halasa, Aristea Velegraki, Christopher C. Dvorak, Arunaloke Charkabarti, Lillian Sung, Lara Danziger-Isakov, Catherine Lachenauer, Antonio Arrieta, Katherine Knapp, Mark J. Abzug, Christine Ziebold, Thomas Lehrnbecher & 7 others Lena Klingspor, Adilia Warris, Kateri Leckerman, Teresa Martling, Thomas J. Walsh, Daniel K. Benjamin, Theoklis E. Zaoutis

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Candida species are the third most common cause of pediatric health care-associated bloodstream infection in the United States and Europe. To our knowledge, this report from the International Pediatric Fungal Network is the largest prospective, multicenter observational study dedicated to pediatric and neonatal invasive candidiasis. METHODS: From 2007 to 2011, we enrolled 196 pediatric and 25 neonatal patients with invasive candidiasis. RESULTS: Non-albicans Candida species predominated in pediatric (56%) and neonatal (52%) age groups, yet Candida albicans was the most common species in both groups. Successful treatment responses were observed in pediatric (76%) and neonatal patients (92%). Infection with Candida parapsilosis led to successful responses in pediatric (92%) and neonatal (100%) patients, whereas infection with Candida glabrata was associated with a lower successful outcome in pediatric patients (55%). The most commonly used primary antifungal therapies for pediatric invasive candidiasis were fluconazole (21%), liposomal amphotericin B (20%) and micafungin (18%). Outcome of pediatric invasive candidiasis was similar in response to polyenes (73%), triazoles (67%) and echinocandins (73%). The most commonly used primary antifungal therapies for neonatal invasive candidiasis were fluconazole (32%), caspofungin (24%) and liposomal amphotericin B (16%) and micafungin (8%). Outcomes of neonatal candidiasis by antifungal class again revealed similar response rates among the classes. CONCLUSIONS: We found a predominance of non-albicans Candida infection in children and similar outcomes based on antifungal class used. This international collaborative study sets the foundation for large epidemiologic studies focusing on the unique features of neonatal and pediatric candidiasis and comparative studies of therapeutic interventions in these populations.

Original languageEnglish (US)
Pages (from-to)1252-1257
Number of pages6
JournalPediatric Infectious Disease Journal
Volume31
Issue number12
DOIs
StatePublished - Dec 2012
Externally publishedYes

Fingerprint

Invasive Candidiasis
Epidemiologic Studies
Newborn Infant
Pediatrics
Candida
Fluconazole
Candidiasis
caspofungin
Infection
Echinocandins
Candida glabrata
Polyenes
Triazoles
Therapeutics
Cross Infection
Candida albicans
Multicenter Studies
Observational Studies

Keywords

  • Antifungal
  • Epidemiology
  • Fungal
  • Invasive candidiasis
  • Pediatric

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Infectious Diseases
  • Microbiology (medical)

Cite this

Steinbach, W. J., Roilides, E., Berman, D., Hoffman, J. A., Groll, A. H., Bin-Hussain, I., ... Zaoutis, T. E. (2012). Results from a prospective, international, epidemiologic study of invasive candidiasis in children and neonates. Pediatric Infectious Disease Journal, 31(12), 1252-1257. https://doi.org/10.1097/INF.0b013e3182737427

Results from a prospective, international, epidemiologic study of invasive candidiasis in children and neonates. / Steinbach, William J.; Roilides, Emmanuel; Berman, David; Hoffman, Jill A.; Groll, Andreas H.; Bin-Hussain, Ibrahim; Palazzi, Debra L.; Castagnola, Elio; Halasa, Natasha; Velegraki, Aristea; Dvorak, Christopher C.; Charkabarti, Arunaloke; Sung, Lillian; Danziger-Isakov, Lara; Lachenauer, Catherine; Arrieta, Antonio; Knapp, Katherine; Abzug, Mark J.; Ziebold, Christine; Lehrnbecher, Thomas; Klingspor, Lena; Warris, Adilia; Leckerman, Kateri; Martling, Teresa; Walsh, Thomas J.; Benjamin, Daniel K.; Zaoutis, Theoklis E.

In: Pediatric Infectious Disease Journal, Vol. 31, No. 12, 12.2012, p. 1252-1257.

Research output: Contribution to journalArticle

Steinbach, WJ, Roilides, E, Berman, D, Hoffman, JA, Groll, AH, Bin-Hussain, I, Palazzi, DL, Castagnola, E, Halasa, N, Velegraki, A, Dvorak, CC, Charkabarti, A, Sung, L, Danziger-Isakov, L, Lachenauer, C, Arrieta, A, Knapp, K, Abzug, MJ, Ziebold, C, Lehrnbecher, T, Klingspor, L, Warris, A, Leckerman, K, Martling, T, Walsh, TJ, Benjamin, DK & Zaoutis, TE 2012, 'Results from a prospective, international, epidemiologic study of invasive candidiasis in children and neonates', Pediatric Infectious Disease Journal, vol. 31, no. 12, pp. 1252-1257. https://doi.org/10.1097/INF.0b013e3182737427
Steinbach, William J. ; Roilides, Emmanuel ; Berman, David ; Hoffman, Jill A. ; Groll, Andreas H. ; Bin-Hussain, Ibrahim ; Palazzi, Debra L. ; Castagnola, Elio ; Halasa, Natasha ; Velegraki, Aristea ; Dvorak, Christopher C. ; Charkabarti, Arunaloke ; Sung, Lillian ; Danziger-Isakov, Lara ; Lachenauer, Catherine ; Arrieta, Antonio ; Knapp, Katherine ; Abzug, Mark J. ; Ziebold, Christine ; Lehrnbecher, Thomas ; Klingspor, Lena ; Warris, Adilia ; Leckerman, Kateri ; Martling, Teresa ; Walsh, Thomas J. ; Benjamin, Daniel K. ; Zaoutis, Theoklis E. / Results from a prospective, international, epidemiologic study of invasive candidiasis in children and neonates. In: Pediatric Infectious Disease Journal. 2012 ; Vol. 31, No. 12. pp. 1252-1257.
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AU - Roilides, Emmanuel

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AU - Hoffman, Jill A.

AU - Groll, Andreas H.

AU - Bin-Hussain, Ibrahim

AU - Palazzi, Debra L.

AU - Castagnola, Elio

AU - Halasa, Natasha

AU - Velegraki, Aristea

AU - Dvorak, Christopher C.

AU - Charkabarti, Arunaloke

AU - Sung, Lillian

AU - Danziger-Isakov, Lara

AU - Lachenauer, Catherine

AU - Arrieta, Antonio

AU - Knapp, Katherine

AU - Abzug, Mark J.

AU - Ziebold, Christine

AU - Lehrnbecher, Thomas

AU - Klingspor, Lena

AU - Warris, Adilia

AU - Leckerman, Kateri

AU - Martling, Teresa

AU - Walsh, Thomas J.

AU - Benjamin, Daniel K.

AU - Zaoutis, Theoklis E.

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N2 - BACKGROUND: Candida species are the third most common cause of pediatric health care-associated bloodstream infection in the United States and Europe. To our knowledge, this report from the International Pediatric Fungal Network is the largest prospective, multicenter observational study dedicated to pediatric and neonatal invasive candidiasis. METHODS: From 2007 to 2011, we enrolled 196 pediatric and 25 neonatal patients with invasive candidiasis. RESULTS: Non-albicans Candida species predominated in pediatric (56%) and neonatal (52%) age groups, yet Candida albicans was the most common species in both groups. Successful treatment responses were observed in pediatric (76%) and neonatal patients (92%). Infection with Candida parapsilosis led to successful responses in pediatric (92%) and neonatal (100%) patients, whereas infection with Candida glabrata was associated with a lower successful outcome in pediatric patients (55%). The most commonly used primary antifungal therapies for pediatric invasive candidiasis were fluconazole (21%), liposomal amphotericin B (20%) and micafungin (18%). Outcome of pediatric invasive candidiasis was similar in response to polyenes (73%), triazoles (67%) and echinocandins (73%). The most commonly used primary antifungal therapies for neonatal invasive candidiasis were fluconazole (32%), caspofungin (24%) and liposomal amphotericin B (16%) and micafungin (8%). Outcomes of neonatal candidiasis by antifungal class again revealed similar response rates among the classes. CONCLUSIONS: We found a predominance of non-albicans Candida infection in children and similar outcomes based on antifungal class used. This international collaborative study sets the foundation for large epidemiologic studies focusing on the unique features of neonatal and pediatric candidiasis and comparative studies of therapeutic interventions in these populations.

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