NHẬN XÉT KẾT QUẢ ĐIỀU TRỊ NHIỄM NẤM XÂM LẤN Ở TRẺ EM TẠI BỆNH VIỆN NHI TRUNG ƯƠNG

Abstract

Objective: Evaluate the treatment outcomes of invasive fungal infections in children at the Pediatric Intensive Care Unit, National Children's Hospital. Subjects and Methods: A descriptive case series study was conducted on 39 patients with invasive fungal infections treated at the Pediatric Intensive Care Unit, National Children's Hospital, from January 2022 to December 2023. Results: The median age of the children was 11,5 months (IQR: 4 - 31 months), with males predominating (69,23%). The primary comorbidities were pneumonia and sepsis, which exacerbated immunosuppression. Candida albicans was the most common pathogen (64,1%), followed by Candida tropicalis (23,1%) and Candida parapsilosis (7,6%). The presence of rare strains such as Candida duobushaemulonii and Candida guilliermondii, though less frequent, raised concerns about drug resistance, necessitating thorough susceptibility testing. Fluconazole was the most commonly used treatment (58,97%) due to its availability and efficacy against Candida albicans. Amphotericin B (5,12%) and Caspofungin (2,56%) were used less frequently, while 20,5% of patients received a combination of two antifungal drugs, and 5,12% received three antifungal drugs, reflecting the complexity of severe cases. The median treatment duration was 16 days (IQR: 9 - 28,25 days), and the median hospital stay was 27 days (IQR:16-44 days), indicating a significant disease burden. The mortality rate was high (53,85%), reflecting the severity of invasive fungal infections, particularly in children with severe underlying conditions. Conclusion: The study highlights that invasive fungal infections predominantly affect young children, with pneumonia and sepsis as the main comorbidities. Candida albicans was the most common pathogen in invasive fungal infections. Fluconazole remains the mainstay of treatment for invasive fungal infections.