A Prospective, International Cohort Study of Invasive Mold Infections in Children.

摘要: Background Invasive mold infections (IMIs) are a leading cause of mortality in immunocompromised children, yet there has never been an international epidemiologic investigation pediatric IMIs. Methods This international, prospective cohort study was performed to characterize the epidemiology, antifungal therapy, and outcomes Children (≤18 years) with proven or probable IMIs were enrolled between August 2007 May 2011 at 22 sites. Risk factors, underlying diagnoses, treatments recorded. Outcomes assessed 12 weeks after diagnosis using European Organization for Research Treatment Cancer/Mycoses Study Group response criteria. Results One hundred thirty-one patients enrolled; most common IMI invasive aspergillosis ([IA] 75%). IA those other types had similar risk except that children caused by non-Aspergillus species more likely have received mold-active agents preceding diagnosis. The commonly used classes triazoles (82%) polyenes (63%). Combination therapy 53% patients. Use combination associated increased adverse events (risk ratio, 1.98; 95% confidence interval, 1.06-3.68; P = .031), although no detectable difference outcome. Conclusions Although factors across specific subtypes, may be important modifier. requires further determine its true risks benefits.