Risk factors of invasive candidiasis in children with leukemia

Summary

Methods

512 children with leukemia were analysed: acute lymphoblastic leukemia (ALL) – 310, acute myeloid leukemia (AML) – 76, relapse of leukemia – 126 children. The median age was 7 years. There were 341 boys (67%) and 171 girls (34%).

To determine a statistical significance of risk factors of IC development the following computing methods and  importance of distinctions criteria were applied: odds ratio (OR), a confidential interval (CI), criterion р, median (Ме).

Results

The frequency of IC was 4.9% (25 patients). The statistically significant risk factors of IC development were the following: relapse of leukemia (OR 0.24, 95% CI 0.06–0.89, p <0.001), treatment of relapse (OR 0.24, 95% CI 0.06–0.91, p <0.001), duration of neutropenia (< 0.5x10⁹/l) more than 14 days (OR 0.35, 95% CI 0.08–1.51, p=0.008), use of carbapenems (OR 0.18, 95% CI 0.06–0.59, p=0.002) and vancomycin (OR 0.23, 95% CI 0.07–0.72, p=0.014).

Conclusions

1. Risk factors of IC development in children with leukemia were the following: relapse of leukemia, treatment of the relapse, duration of neutropenia more than 14 days, the use of carbapenems and vancomycin for the antibacterial treatment. 2. Patients with risk factors of IC should receive systemic antifungal prophylaxis to prevent the development of life-threatening infection.

Keywords

leukemia, children, invasive candidiasis, risk factors