Identification of pathogenic fungi in pediatric oncology patients

DOI
  • Hino Moeko
    Department of Pediatrics, Graduate School of Medicine, Chiba University
  • Ishiwada Naruhiko
    Division of Infection Control and Prevention, Medical Mycology Research Center
  • Aoki Takahiro
    Department of Pediatrics, Graduate School of Medicine, Chiba University
  • Okada Reona
    Department of Pediatrics, Graduate School of Medicine, Chiba University
  • Okunushi Tomoko
    Department of Pediatrics, Graduate School of Medicine, Chiba University
  • Okusu Misako
    Division of Infection Control and Prevention, Medical Mycology Research Center
  • Watanabe Akira
    Division of Clinical Research, Medical Mycology Research Center
  • Kamei Katsuhiko
    Division of Clinical Research, Medical Mycology Research Center
  • Shimojo Naoki
    Department of Pediatrics, Graduate School of Medicine, Chiba University

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Other Title
  • 過去10年間に当院小児がん患者から分離された真菌に関する検討
  • —A single-center experience—

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<p>The identification of pathogenic fungi is difficult in pediatric oncology patients. We retrospectively analyzed the clinical courses and susceptibilities of 2 filamentous fungi and 5 yeasts isolated from 6 patients who were treated in our institution between January 2004 and December 2014. Aspergillus terreus was isolated repeatedly from the ear discharge of a patient with otitis externa during neutropenia. In accordance with susceptibility test results, the patient safely received stem cell transplantation with voriconazole (VRCZ) combined with micafungin (MCFG). All the yeasts detected in the patients with bloodstream infections were Candida species. Although the β-D-glucan titer increased and the clinical manifestation of splenic abscess worsened, we treated C. tropicalis infection with MCFG only on the basis of the susceptibility test results. Although C. glabrata is sensitive to MCFG, the C. glabrata from our patient showed a high minimum inhibitory concentration against MCFG. Recently, echinocandin resistance to Candida has been increasing in the United States. Therefore, the identification of pathogenic fungi and drug susceptibility test results will become more important for treating pediatric oncology patients.</p>

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