Increase of Fungal Endocarditis in Children
| Autor: | Edgard Jaeggi, Maurice Beghetti, Alain Gervaix, Pierre Tissières |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
Catheterization
Central Venous/adverse effects Male Microbiology (medical) Catheterization Central Venous medicine.medical_specialty Adolescent Heart disease medicine.drug_class Critical Illness medicine.medical_treatment Antibiotics Disease Sepsis Risk Factors Internal medicine Epidemiology medicine Humans Endocarditis/epidemiology Hospitals Pediatric/statistics & numerical data Child Retrospective Studies ddc:618 Endocarditis business.industry Incidence Incidence (epidemiology) Infant Newborn Infant General Medicine Hospitals Pediatric medicine.disease Anti-Bacterial Agents Surgery Anti-Bacterial Agents/therapeutic use Infectious Diseases Mycoses Child Preschool Infective endocarditis Female Mycoses/epidemiology business Central venous catheter |
| Zdroj: | Infection, Vol. 33, No 4 (2005) pp. 267-72 |
| ISSN: | 1439-0973 0300-8126 |
| DOI: | 10.1007/s15010-005-4122-4 |
| Popis: | Background:: Infective endocarditis (IE) is a rare and feared infection that mainly occurs in patients with underlying cardiac disease or altered function of the immune system. Recent epidemiological data on both sepsis and nosocomial infections indicate a rise in gram-negative bacterial and fungal infection, particularly in patients requiring critical care support. This study sought to characterize the change in the spectrum of IE encountered in a single pediatric tertiary care center during the last 18 years, to evaluate emergence of fungal IE and to identify contributing factors. Patients and Methods:: Review of all cases of IE diagnosed between January 1986 and August 2003 at a single university children's hospital. Patients were distributed between two equal time periods and compared according to the era of IE diagnosis. Results:: In 43 patients, 44 episodes of IE were identified with most cases occurring in children with congenital or acquired heart disease. The annual number of diagnosed cases fluctuated during the study (mean 2.4 cases/year). Blood or specimen cultures were positive in 34 cases (77%) with gram-positive organisms most frequently observed (n = 20, 44.4%). Fungal IE cases (n = 9, 20%) occurred preferentially during the second period (p < 0.03), and were more common in children with noncardiac diseases (p = 0.023). Factors associated with fungal IE were the use of broad-spectrum antibiotics (p < 0.001) and the presence of an infected central venous catheter (p = 0.01). Overall mortality did not differ between the two eras. Conclusion:: The incidence of fungal IE seems to have significantly increased in more recent years. Use of broadspectrum antibiotics for prolonged time or/and central venous catheters were identified as predisposing factors to fungal infective endocarditis |
| Databáze: | OpenAIRE |
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