A study on clinical profile of invasive fungal infection in neutropenic children in a tertiary care teaching hospital

Masoom Nathani; Piali Mandal; Ravinder Kaur; Jagadish Chandra

doi:10.18203/2349-3291.ijcp20221858

Authors

Masoom Nathani Department of Microbiology, Maulana Azad Medical College, New Delhi, India
Piali Mandal Department of Pediatrics, Kalawati Saran Children’s Hospital, New Delhi, India
Ravinder Kaur Department of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
Jagadish Chandra Department of Pediatrics, Kalawati Saran Children’s Hospital, New Delhi, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20221858

Keywords:

Children, Neutropenia, Invasive fungal infection

Abstract

Background: Febrile neutropenia is a common complication of anti-cancer chemotherapy. Invasive fungal infections are found mostly after prolonged neutropenia. Early diagnosis and treatment of these infections are of crucial importance. Hence, there is a need to identify the common causative organisms of fungal sepsis in children and our primary objective was to diagnose invasive fungal infections in children of febrile neutropenia and identify the common fungal etiological agents with clinical profile.

Methods: This study was done as observational, cross-sectional study for 18 months at the department of microbiology, Lady Hardinge Medical College and department of pediatrics, Kalawati Saran Children’s Hospital. All children less than 18 years of age clinically suspected to have invasive fungal infection with absolute neutrophil count <500 /ml, with fever not responding to antibiotics for more than 3-4 days were included in the study.

Results: Hospitalization ≥7 days (100%) was the most common associated risk factor, followed by neutropenia (100%), immunodeficiency (100%), cytotoxic drugs (87.27%) and malignancies (87.27%). Other less commonly associated risk factors were hyperalimentation (23.64%), residence near a construction site (23.64%), presence of urinary catheters (10.91%) and HIV positivity (9.09%). Around 54.54% of sputum samples were positive for fungal culture. A lower positivity was seen in blood culture (14.54%).

Conclusions: Candida spp., Aspergillus spp. and Pneumocystis remain the primary fungal pathogens in this patient population. Early clinical suspicion followed by prompt sampling and evaluation for fungal infections may aid in timely diagnosis and reduction of mortality of these patients.

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Author Biography

Masoom Nathani, Department of Microbiology, Maulana Azad Medical College, New Delhi, India

SENIOR RESIDENT

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