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J. Fungi 2019, 5(1), 11; https://doi.org/10.3390/jof5010011

Invasive Candidiasis in Infants and Children: Recent Advances in Epidemiology, Diagnosis, and Treatment

1
Departments of Medicine, Pediatrics, and Microbiology & immunology, Weill Cornell Medicine of Cornell University and New York Presbyterian Hospital, New York, NY 10065, USA
2
Department of Pediatrics, Division of Pediatric Infectious Diseases, Nationwide Children’s Hospital and The Ohio State University School of Medicine, Columbus, OH 43205, USA
3
Pediatric Infectious Diseases, Department of Pediatrics, Miller Children’s Hospital and University of California Irvine, Long Beach, CA 90806, USA
4
Department of Pediatrics, Division of Pediatric Infectious Diseases, Weill Cornell Medicine of Cornell University and New York Presbyterian Hospital, New York, NY 10065, USA
5
Infectious Diseases Section, 3rd Department of Pediatrics, Faculty of Medicine, Aristotle University School of Health Sciences and Hippokration General Hospital, 54642 Thessaloniki, Greece
*
Author to whom correspondence should be addressed.
Received: 5 December 2018 / Revised: 10 January 2019 / Accepted: 17 January 2019 / Published: 24 January 2019
(This article belongs to the Special Issue Fungal Infections in Immunocompromised Hosts)
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PDF [249 KB, uploaded 24 January 2019]

Abstract

This paper reviews recent advances in three selected areas of pediatric invasive candidiasis: epidemiology, diagnosis, and treatment. Although the epidemiological trends of pediatric invasive candidiasis illustrate a declining incidence, this infection still carries a heavy burden of mortality and morbidity that warrants a high index of clinical suspicion, the need for rapid diagnostic systems, and the early initiation of antifungal therapy. The development of non-culture-based technologies, such as the T2Candida system and (1→3)-β-d-glucan detection assay, offers the potential for early laboratory detection of candidemia and CNS candidiasis, respectively. Among the complications of disseminated candidiasis in infants and children, hematogenous disseminated Candida meningoencephalitis (HCME) is an important cause of neurological morbidity. Detection of (1→3)-β-d-glucan in cerebrospinal fluid serves as an early diagnostic indicator and an important biomarker of therapeutic response. The recently reported pharmacokinetic data of liposomal amphotericin B in children demonstrate dose–exposure relationships similar to those in adults. The recently completed randomized clinical trial of micafungin versus deoxycholate amphotericin B in the treatment of neonatal candidemia provides further safety data for an echinocandin in this clinical setting. View Full-Text
Keywords: candidemia; Candida meningoencephalitis; (1→3)-β-d-glucan; T2Candida; PCR; liposomal amphotericin B; micafungin; anidulafungin candidemia; Candida meningoencephalitis; (1→3)-β-d-glucan; T2Candida; PCR; liposomal amphotericin B; micafungin; anidulafungin
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Walsh, T.J.; Katragkou, A.; Chen, T.; Salvatore, C.M.; Roilides, E. Invasive Candidiasis in Infants and Children: Recent Advances in Epidemiology, Diagnosis, and Treatment. J. Fungi 2019, 5, 11.

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