FUNGAL INFECTIONS

[Guest guest]

Fungal Infections: Epidemiology and Risk Factors

Invasive Fungal Infections in Pediatric Oncology Patients: 11-Year

Experience at a Single Institution

Rosen GP, Nielsen K, Glenn S, Abelson J, Deville J, TB

J Pediatr Hematol Oncol . 2005;27:135-140

The purpose of this study was to determine the incidence of fungal infections

in pediatric hematology and oncology (PHO) patients and to describe

variations regarding site of infection, organisms, and mortality. The records

of

1,052 patients presenting to the UCLA PHO service with various malignancies

from

1991 to 2001 were retrospectively reviewed. No patient received invasive

antifungal prophylaxis. Transplant patients were excluded. The 11-year

incidence

of fungal infections in this pediatric oncology cohort was 4.9%. There was a

linear increase in the incidence of fungal infections from 2.9% to 7.8%

between 1996 and 2001 (P = 0.001). Patients with acute leukemia represented 36%

of

the population but had a disproportionate incidence (67%) of fungal

infections. Adolescents had twice the expected incidence of infection (P <

0.0001).

Overall, Candida sp. was the major pathogen. Over time, a trend of fewer

infections caused by Candida and more due to Aspergillus was noted. Blood-borne

infections decreased over time, while those in the urinary and respiratory

tracts increased (P = 0.04). Sixty-two percent of infections occurred in

neutropenic patients. PHO patients had an overall mortality of 21%, but those

with

fungal infections experienced a 2.6-fold higher mortality that was not

attributable to infections alone. Empiric antifungal therapy had no effect on

mortality rates. Concurrent nonfungal infections did not increase mortality

rates.

The incidence of fungal infections increased over time, possibly as a result

of advances in antibacterial and chemotherapeutic regimens. Adolescents and

patients with leukemia were especially at risk. Fungal infections are a poor

prognostic factor, independent of fungal-related mortality. New diagnostic

methods allowing for early detection and treatment as well as more effective

therapies are needed.

[Guest guest]

Doctors for some odd reason don't want to be in the postition of having to go to

court to testify. They know.

Lori K.

[Guest guest]

> Doctors for some odd reason don't want to be in the position of

having to go to court to testify. They know.

> Lori K.

Can't blame 'em.

If you saw how the CDC tried to destroy Dr Cheney and Dr

during the Incline Village epidemic as detailed in Osler's Web, you'd

certainly think twice about tangling with the feds.

Offical Motto " We're Here To Help " ...

Unofficial Corollary: " ...Destroy your career if you don't toe the

line " .

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