Candida lusitaniae Fungemia in Children: A multicenter case series of emerging pathogen.

Abstract

Candida lusitaniae fungemia is a serious infection which is rarely reported in children. The aim of this study is to describe a case series of Candida lusitaniae fungemia and review previous publications regarding this rare pathogen. This is a multicenter case series of children diagnosed with Candida lusitaniae fungemia. Eighteen cases which occurred over a 15-year period in 5 tertiary hospitals were included. Additionally, a review of the literature regarding Candida lusitaniae fungemia in children was performed. Eighteen cases were enrolled, 11/18 (61%) were males, with a mean age of 2.3 years. All patients had severe underlying diseases and risk factors for opportunistic infection, most commonly prematurity and malignancies. More than one third of cases occurred during the last two years of the study period. All isolates were susceptible to all tested antifungals. Survival rate following the acute infection was 94% whereas survival rate of 14 previously published cases was 71% with the most common underlying diseases being CGD and malignancies. Candida lusitaniae fungemia is not a common event in the pediatric population, occurring exclusively in children with severe underlying diseases and significant risk factors. This cohort revealed better clinical outcomes than previously reported. All tested isolates were susceptible to all antifungal agents, variability in susceptibility as previously reported was not found in this study. The allegedly higher rate of infection in recent years is in need of further investigation in larger prospective studies in order to conclude if a real trend is at play.