Creus-Costa A, Pinyol-Sarrias M, Lozano-Durán D, Rincón-López EM, Navarro ML, Guinea J, Carazo-Gallego B, Soler-Palacín P, Mendoza-Palomar N, Martín-Gómez MT

Language: Spanish
References: 32
Page: 149-155
PDF size: 315.88 Kb.

ABSTRACT

Introduction: invasive aspergillosis (IA) represents one of the most frequent invasive fungal infections in pediatric patients with risk factors. An increase in cases of azole-resistant IA has been reported in adult patients. The aim of this study is to present a series of six cases of pediatric patients with this pathology. Material and methods: a retrospective descriptive study was conducted, collecting data from patients with probable or proven azole-resistant IA between January 2019 and June 2024 in three tertiary pediatric hospitals in Spain. Results: six cases are reported, all patients with risk factors for IA (four with hematologic diseases and two with heart transplant). Three of them were receiving prophylaxis with posaconazole and two with liposomal amphotericin B. The most frequently isolated species was A. fumigatus. Although azole resistance was detected relatively late, all patients received some active antifungal treatment from the diagnosis of IA. Despite this and the multimodal treatment, the attributable mortality was high (4/6 patients). Conclusion: azole-resistant IA should be suspected in pediatric patients with risk factors, especially if they show poor clinical evolution or have received azole prophylaxis. The performance of invasive tests, as well as species identification and resistance testing, is essential to optimize treatment.

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