دورية أكاديمية
Invasive Fungal Infections in the Paediatric Intensive Care Unit: A Hong Kong Study.
| العنوان: | Invasive Fungal Infections in the Paediatric Intensive Care Unit: A Hong Kong Study. |
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| المؤلفون: | Li MWT; Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong, China., Hon KL; Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong, China., Yan Leung KK; Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong, China., Hui WF; Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong, China., Lung DC; Department of Pathology, Queen Elizabeth Hospital/The Hong Kong Children's Hospital, Hong Kong, China., Ha SY; Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong, China. |
| المصدر: | Current pediatric reviews [Curr Pediatr Rev] 2024; Vol. 20 (4), pp. 540-547. |
| نوع المنشور: | Case Reports; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Bentham Science Publishers Country of Publication: United Arab Emirates NLM ID: 101240290 Publication Model: Print Cited Medium: Internet ISSN: 1875-6336 (Electronic) Linking ISSN: 15733963 NLM ISO Abbreviation: Curr Pediatr Rev Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Saif Zone, Sharjah, U.A.E. ; San Francisco, CA : Bentham Science Publishers, 2005- |
| مواضيع طبية MeSH: | Intensive Care Units, Pediatric*/statistics & numerical data , Invasive Fungal Infections*/diagnosis , Invasive Fungal Infections*/epidemiology , Invasive Fungal Infections*/therapy , Invasive Fungal Infections*/mortality , Invasive Fungal Infections*/drug therapy, Humans ; Retrospective Studies ; Child ; Male ; Female ; Child, Preschool ; Hong Kong/epidemiology ; Infant ; Risk Factors ; Adolescent ; Incidence ; Antifungal Agents/therapeutic use ; Infant, Newborn |
| مستخلص: | Introduction: Invasive fungal infections (IFI) cause significant mortality and morbidity in the Paediatric Intensive Care Unit (PICU). Early recognition and prompt treatment of invasive fungal infections are important. This article reviewed the mortality and morbidity of IFIs in the PICU of Hong Kong Children's Hospital. Methods: A retrospective review of all PICU admissions from April 2019 to May 2021 was performed. The following data were retrieved: age, gender, diagnosis, comorbidity, clinical manifestation, type of fungus, duration of stay at PICU, absolute neutrophil count, use of immunosuppressive therapy, presence of central venous catheter and use of total parental nutrition. The primary outcomes were the incidence and mortality of IFIs among PICU patients. The secondary outcomes were risk factors for developing IFI in PICU and clinical course of IFIs. Numerical variables were compared between groups by Mann-Whitney U test and categorical variables by Fisher's exact test. Results: There were 692 PICU admissions over the study period from April 2019 to May 2021. The crude mortality was 3% (n=24 death cases) in the PICU. Fourteen patients (2%) fulfilling the criteria for IFIs were identified using hospital electronic record system and according to PICU documentation. Eight of these 14 patients (57%) had hematological malignancy, 2 (17%) had solid tumours and 4 had non-oncological conditions. Eight (57%) patients were neutropenic with absolute neutrophil count less than 1x 109 at diagnosis of IFI. Ten (71%) had received immunosuppressive therapy including steroid, cyclosporin A, Mycophenolate mofetil (MMF), Sirolimus or tacrolimus. 12 (86%) had had central venous catheter. Eight (57%) were on parenteral nutrition. IFIs due to Rhizopus or Aspergillus infection (5/14), or in post-haematopoietic stem cell transplant patients (5/14) were associated with non-survival (p = 0.031). Conclusion: All patients with IFIs managed in the PICU had haemato-oncology diseases or were recipients of stem cell transplantation. IFIs with Rhizopus or Aspergillus as a group were associated with high mortality in the PICU. Awareness of this pathology with prompt diagnosis and treatment may improve the outcome of these infections and reduce the mortality. (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.) |
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| فهرسة مساهمة: | Keywords: Critical care; PICU; haemato-oncologic diseases; invasive fungal infection; mortality.; stem cell transplantation |
| المشرفين على المادة: | 0 (Antifungal Agents) |
| تواريخ الأحداث: | Date Created: 20230823 Date Completed: 20240812 Latest Revision: 20240812 |
| رمز التحديث: | 20240813 |
| DOI: | 10.2174/1573396320666230811092915 |
| PMID: | 37608678 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1875-6336 |
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| DOI: | 10.2174/1573396320666230811092915 |