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  Česky / Czech version Čes.-slov. Pediat, 2007, roč. 62, č. 12, s, 664-673,
 
Invasive Mycotic Infection at the Clinic of Children Oncology, Faculty Hospital Brno, 2002-2006 
Toušovská K.1, Dembická D.1, Lokaj P.1, Múdry P.1, Kocmanová I.2, Skotáková J.3, Habanec P.4, Štěrba J.1 

Klinika dětské onkologie LF MU Brno a FN Brno1 přednosta prof. MUDr. J. Štěrba, PhD. Oddělení klinické mikrobiologie FN Brno2 primářka MUDr. A. Ševčíková Klinika dětské radiologie LF MU Brno a FN Brno3 přednostka doc. MUDr. J. Skotáková, CSc. Ústav patologie LF MU Brno a FN Brno4 přednosta prof. MUDr. J. Mačák, CSc.
 


Summary:

       Introduction: Invasive mycotic infections (IFI) are redoubtable complications in the therapy of patients with oncology diagnosis. Their lethality reaches up to 80% and the economic aspects of the therapy are also not negligible. Incidence of IFI within the framework of individual workplaces may differ in relation to the structure of the patients' cohort, antibiotic and antimycotic therapeutic policy and epidemiological conditions of the workplace. The objective of this investigation was to determine incidence of IFI at the authors' workplace weight years since the foundation. Methods: The authors retrospectively evaluated clinical, microbiological and radio-logical data of the patients with consumption of systemic antimycotics and applied consensual diagnostic criteria of IFI for all of them. Results: In the given period of time 562 patients háve been treated at the clinic, 14 of them (2.5%) having established the diagnosis of IFI. In 10 of the patients IFI diagnosis was certain, probable in one patient and possible in three others. In nice cases there was an invasive candidosis (IC), in four cases invasive aspergillosis (IA) and one patient suffered from invasive zygomycosis. The proved agents in six cases of IC were strains of C. non albicans, and C. albicans in three patients. The basic diagnosis of acu-te myeloid leukemia or myelodysplastic syndrome (AML/MDS) and meduUoblastoma (MBL) was associated with 11.9 and 5.4-fold increased risk of IFI, respectively. Prophylactic administration of ancimycotics in the colonized patients failed in the prevention of IFI. Two patients died due to IFI (14.2%). There háve not been any difference in mortality between neutropenic and non- neutropenic patients. Conclusion: The incidence of IFI has not differed from the published data. The ten-dency for Íncreasing IFI incidence over the last two years and a high proportion of C. non albicans strains among agents of invasive candidoses represents a serious finding. For the patients with AML/MDS who are at the highest risk, primary antimycotic prophylaxis may be useful. It should be at best performed in conditions of muticentric controlled study.

        Key words: invasive mycotic infection, malignity, incidence, therapy, mortality
       

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