Candida lusitaniae Fungemia in Children: A multicenter case series of emerging pathogen

Author:

Snapiri Ori1ORCID,Danziger Chen Rosenberg1,Sachs Nimrod12,Krause Irit13,Zvi Haim Ben34,Danino Dana56ORCID,Kriger Or7,Shachor-Meyouhas Yael89,Averbuch Dina10,Bilavsky Efraim123

Affiliation:

1. Department of Pediatrics C, Schneider Children’s Medical Center of Israel , Petah Tikva , Israel

2. The Pediatric Infectious Disease Unit, Schneider Children's Medical Center of Israel , Petah Tikva , Israel

3. Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel

4. Clinical Microbiology Laboratory, Rabin Medical Center, Beilinson Hospital , Petah-Tikva , Israel

5. Faculty of Health and Sciences, Ben Gurion University , Beer Sheva , Israel

6. The Pediatric Infectious Disease Unit, Soroka Medical Center , Beer Sheva , Israel

7. Clinical Microbiology, Sheba Medical Center , Ramat-Gan , Israel

8. Pediatric Infectious Disease Unit and management, Rambam Health Care Campus , Haifa , Israel

9. The Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Thechnology , Haifa , Israel

10. Pediatric Infectious Diseases, Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem , Jerusalem , Israel

Abstract

Abstract Candida lusitaniae fungemia is a serious infection that is rarely reported in children. The aim of this study is to describe a case series of C. lusitaniae fungemia and review previous publications regarding this rare pathogen. This is a multicenter case series of children diagnosed with C. lusitaniae fungemia. A total of 18 cases that occurred over a 15-year period in five tertiary hospitals were included. Additionally, a review of the literature regarding C. lusitaniae fungemia in children was performed. A total of 18 cases were enrolled; 11/18 (61%) were males, with a mean age of 2.3 years. All patients had severe underlying diseases and risk factors for opportunistic infection, most commonly prematurity and malignancies. More than one-third of cases occurred during the last 2 years of the study period. All isolates were susceptible to all tested antifungals. The survival rate following the acute infection was 94%, whereas the survival rate of 14 previously published cases was 71%, with the most common underlying diseases being CGD and malignancies. Candida lusitaniae fungemia is not a common event in the pediatric population, occurring exclusively in children with severe underlying diseases and significant risk factors. This cohort revealed better clinical outcomes than previously reported. All tested isolates were susceptible to all antifungal agents; variability in susceptibility as previously reported was not found in this study. The allegedly higher rate of infection in recent years is in need of further investigation in larger prospective studies in order to conclude if a real trend is at play.

Publisher

Oxford University Press (OUP)

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