癌症患儿侵袭性真菌病的流行病学变化:智利国家儿童抗肿瘤药物计划网络的前瞻性研究。

IF 4.1 2区 医学 Q1 DERMATOLOGY
Mycoses Pub Date : 2024-08-01 DOI:10.1111/myc.13780
Marlon Barraza, Romina Valenzuela, Milena Villarroel, Verónica de la Maza, Verónica Contardo, Ana María Álvarez, Valentina Gutiérrez, Marcela Zubieta, Daniela Martínez, María E Santolaya
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引用次数: 0

摘要

背景:侵袭性真菌病(IFD)是高危发热性中性粒细胞减少症(HRFN)患儿中的高发病率和高死亡率感染。IFD 流行病学在过去二十年中发生了变化,近年来发病率不断上升,原因是有 IFD 风险的免疫力低下儿童越来越多。本研究旨在评估智利六家医院2016-2020年与2004-2006年癌症患儿IFD的发病率:方法:前瞻性多中心研究,2016 年至 2020 年期间在智利六家医院进行。所定义的队列与患者中的 HRFN 病例动态组相对应:共分析了777例HRFN病例,其中257例(33.1%)被认为是持续性HRFN,发生在174名患者身上。中位年龄为 7 岁(IQR:3-12 岁),52.3%(N = 91)为男性。共发现 53 例 IFD:21 例经证实,14 例可能,18 例可能。排除了可能的 IFD,剩下 239 例持续性-HRFN,IFD 发生率为 14.6%(95% CI 10.5-19.9),每 1000 天中性粒细胞减少的 IFD 发生率为 13.6 例(95% CI 9.5-20.0)。与 2004-2006 年队列相比(发病率:8.5% (95% CI)与2004-2006年队列(发病率:8.5%(95% CI 5.2-13.5))相比,2016年至2020年队列的发病率显著增加了6.1%(95% CI 0.2-12.1,p = .047):结论:与 2004-2006 年期间相比,我们观察到 2016-2020 年间 IFD 的发病率明显增加。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Epidemiological changes of invasive fungal disease in children with cancer: Prospective study of the National Child Program of Antineoplastic Drugs network, Chile.

Background: Invasive fungal diseases (IFD) are high morbidity and mortality infections in children with cancer suffering episodes of high-risk febrile neutropenia (HRFN). IFD epidemiology has changed in the last two decades, with an increasing incidence in recent years due to the growing number of immunocompromised children at risk for IFD. The aim of this study was to evaluate the incidence of IFD in children with cancer in the period 2016-2020 compared to 2004-2006 in six hospitals in Chile.

Methods: Prospective, multicentre study, carried out between 2016 and 2020 in six hospitals in Chile. The defined cohort corresponds to a dynamic group of HRFN episodes in patients <18 years old with cancer, who at the fourth day of evolution still presented fever and neutropenia (persistent HRFN). Each episode was followed until resolution of FN. The incidence of IFD was calculated between 2016 and 2020 and compared with data obtained in the period 2004-2006. The incidence rate was estimated.

Results: A total of 777 episodes of HRFN were analysed; 257 (33.1%) were considered as persistent-HRFN occurring in 174 patients. The median age was 7 years (IQR: 3-12 years) and 52.3% (N = 91) were male. Fifty-three episodes of IFD were detected: 21 proven, 14 probable and 18 possible. Possible IFD were excluded, leaving 239 episodes of persistent-HRFN with an IFD incidence of 14.6% (95% CI 10.5-19.9) and an incidence rate of 13.6 IFD cases per 1000 days of neutropenia (95% CI 9.5-20.0). Compared to 2004-2006 cohort (incidence: 8.5% (95% CI 5.2-13.5)), a significant increase in incidence of 6.1% (95% CI 0.2-12.1, p = .047) was detected in cohorts between 2016 and 2020.

Conclusion: We observed a significant increase in IFD in 2016-2020, compared to 2004-2006 period.

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来源期刊
Mycoses
Mycoses 医学-皮肤病学
CiteScore
10.00
自引率
8.20%
发文量
143
审稿时长
6-12 weeks
期刊介绍: The journal Mycoses provides an international forum for original papers in English on the pathogenesis, diagnosis, therapy, prophylaxis, and epidemiology of fungal infectious diseases in humans as well as on the biology of pathogenic fungi. Medical mycology as part of medical microbiology is advancing rapidly. Effective therapeutic strategies are already available in chemotherapy and are being further developed. Their application requires reliable laboratory diagnostic techniques, which, in turn, result from mycological basic research. Opportunistic mycoses vary greatly in their clinical and pathological symptoms, because the underlying disease of a patient at risk decisively determines their symptomatology and progress. The journal Mycoses is therefore of interest to scientists in fundamental mycological research, mycological laboratory diagnosticians and clinicians interested in fungal infections.
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