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Article ; Online: Pediatric mucormycosis associated with COVID-19: A systematic review of clinical cases.

Amaral, Laura Batista / Carlesse, Fabianne / Rossato, Luana

Enfermedades infecciosas y microbiologia clinica (English ed.)

2024

Abstract: The occurrence of mucormycosis has been observed in individuals with COVID-19. However, there is limited information on the epidemiological factors, presentation, diagnostic certainty, and outcome of this infection in children. PubMed, MEDLINE, Scopus, ... ...

Abstract	The occurrence of mucormycosis has been observed in individuals with COVID-19. However, there is limited information on the epidemiological factors, presentation, diagnostic certainty, and outcome of this infection in children. PubMed, MEDLINE, Scopus, Embase, Web of Science, LitCovid, and back-references of the identified manuscripts were systematically searched from December 2019 to March 2023. We have identified 14 cases of pediatric mucormycosis in patients with COVID-19. The median age of patients was 10.7 years. Among these cases, 10 were associated with active COVID-19. In 7 cases, the patients had pre-existing diabetes mellitus and concomitant diabetic ketoacidosis. Corticosteroids were administered to treat COVID-19 in 7 of the patients. The most common clinical presentation of the disease was rhino-orbital cerebral mucormycosis. Seven patients died (50%). Given the high mortality rate, clinicians should maintain a high level of clinical suspicion of mucormycosis in pediatric patients with COVID-19.
Language	English
Publishing date	2024-01-11
Publishing country	Spain
Document type	Journal Article ; Review
ISSN	2529-993X
ISSN (online)	2529-993X
DOI	10.1016/j.eimce.2023.11.006
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Article ; Online: Epidemiology of bloodstream infections and the impact of antimicrobial resistance in pediatric hematopoietic cell transplant.

Carlesse, Fabianne / Russo, Chiara / Seber, Adriana / Castagnola, Elio

Transplant infectious disease : an official journal of the Transplantation Society

2024 Volume 26, Issue 1, Page(s) e14228

Abstract: Bloodstream infections (BSI) pose a substantial threat to the well-being and survival of patients undergoing hematopoietic stem cell transplantation (HSCT). Risk factors for these infections vary across the different post-HSCT phases. In the pre- ... ...

Abstract	Bloodstream infections (BSI) pose a substantial threat to the well-being and survival of patients undergoing hematopoietic stem cell transplantation (HSCT). Risk factors for these infections vary across the different post-HSCT phases. In the pre-engraftment period, patients are particularly susceptible to infection due to prolonged neutropenia, mucosal damage, and extensive use of central venous line (CVL). In the post-engraftment phase, the emergence of graft versus host diseases further compounds the risk. The epidemiology of these infections has undergone notable changes over the years due to multifactorial reasons, including the evolution of protocols that intensify immunosuppression. In this context, the emergence of multi-drug resistance (MDR) microorganisms can be a challenge due to the elevated risk of mortality in these vulnerable patients. Unfortunately, there is a lack of comprehensive data on this topic, particularly in pediatrics. This article aims to provide a summary of the epidemiology of BSI in the different post-transplant phases and the impact of MDR pathogens. Having knowledge about the local epidemiology of BSI can be instrumental in tailoring targeted therapies, leading to improved survival rates in HSCT recipients.
MeSH term(s)	Humans ; Child ; Hematopoietic Stem Cell Transplantation/adverse effects ; Anti-Bacterial Agents/therapeutic use ; Bacteremia/drug therapy ; Bacteremia/epidemiology ; Bacteremia/etiology ; Retrospective Studies ; Drug Resistance, Bacterial ; Sepsis/drug therapy ; Risk Factors
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2024-01-05
Publishing country	Denmark
Document type	Journal Article ; Review
ZDB-ID	1476094-0
ISSN	1399-3062 ; 1398-2273
ISSN (online)	1399-3062
ISSN	1398-2273
DOI	10.1111/tid.14228
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Zs.A 5100: Show issues

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Article ; Online: Children and fungal priority pathogens.

McMullan, Brendan / Govender, Nelesh / Carlesse, Fabianne / Singhal, Tanu / Sati, Hatim / Warris, Adilia

The Lancet. Child & adolescent health

2024

Language	English
Publishing date	2024-04-19
Publishing country	England
Document type	Journal Article
ISSN	2352-4650
ISSN (online)	2352-4650
DOI	10.1016/S2352-4642(24)00056-7
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Article ; Online: Pediatric Cryptococcosis.

Gifford, Alison / Jayawardena, Naamal / Carlesse, Fabianne / Lizarazo, Jairo / McMullan, Brendan / Groll, Andreas H / Warris, Adilia

The Pediatric infectious disease journal

2024 Volume 43, Issue 4, Page(s) 307–312

Abstract: Background: Seroprevalence studies have shown that 70% of children are exposed to Cryptococcus , the most common cause of meningitis in people living with human immunodeficiency virus (HIV), but reported pediatric disease prevalence is much lower than ... ...

Abstract	Background: Seroprevalence studies have shown that 70% of children are exposed to Cryptococcus , the most common cause of meningitis in people living with human immunodeficiency virus (HIV), but reported pediatric disease prevalence is much lower than in adults. Methods: PubMed and Ovid Global Health databases were searched with the terms "cryptococcosis," "cryptococcal meningitis," " Cryptococcus neoformans " or " Cryptococcus gattii ." All studies reporting pediatric specific data in the English language from 1980 up until December 2022 were included. Results: One hundred sixty-eight publications were reviewed totaling 1469 children, with the majority reported from Africa (54.2%). Sixty-five percent (961) were HIV positive, 10% (147) were non-HIV immunocompromised and 19% (281) were immunocompetent. Clinical signs and symptoms were only reported for 458 children, with fever (64%), headache (55%) and vomiting (39%) being the most common. Most children (80%) suffered from meningoencephalitis. Lung involvement was rarely described in HIV-positive children (1%), but significantly more common in the non-HIV immunocompromised (36%) and immunocompetent (40%) groups ( P < 0.0001). Only 22% received the recommended antifungal combination therapy, which was significantly higher in immunocompetent children than those with HIV (39% vs. 6.8%; P < 0.0001). Overall mortality was 23%. A significant higher mortality was observed in children with HIV compared with immunocompetent children (32% vs. 16%; P < 0.001), but not compared with children with non-HIV immunosuppression (25). Conclusions: This is the largest review of pediatric cryptococcosis with new observations on differences in clinical presentation and outcome depending on the underlying condition. The lack of granular clinical data urges prospective clinical epidemiological studies for improved insight in the epidemiology, management and outcome of cryptococcosis in children.
MeSH term(s)	Adult ; Humans ; Child ; Prospective Studies ; Seroepidemiologic Studies ; Cryptococcosis/drug therapy ; Cryptococcosis/epidemiology ; Cryptococcosis/diagnosis ; Cryptococcus neoformans ; HIV Seropositivity
Language	English
Publishing date	2024-01-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	392481-6
ISSN	1532-0987 ; 0891-3668
ISSN (online)	1532-0987
ISSN	0891-3668
DOI	10.1097/INF.0000000000004216
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Article: Invasive fungal infections in pediatric patients with central nervous system tumors: novel insights for prophylactic treatments?

Dassi, Natália / Cappellano, Andrea Maria / da Silva, Adriana Maria Paixão de Sousa / da Silva, Nasjla Saba / Carlesse, Fabianne Altruda de Moraes Costa

Frontiers in oncology

2023 Volume 13, Page(s) 1248082

Abstract: Background and aims: Invasive fungal disease (IFD) poses significant morbidity and mortality risks, especially in pediatric patients with neoplastic diseases. However, there is a notable lack of data concerning patients with central nervous system (CNS) ...

Abstract	Background and aims: Invasive fungal disease (IFD) poses significant morbidity and mortality risks, especially in pediatric patients with neoplastic diseases. However, there is a notable lack of data concerning patients with central nervous system (CNS) tumors. Considering vulnerability factors to infections such as neutropenia, corticosteroids, chemotherapy, surgical interventions, and others, this study aims to evaluate the incidence of IFD in pediatric patients with CNS tumors and determine appropriate indications for prophylactic measures. This is a single-center, retrospective study conducted between 2011 and 2022 at the Pediatric Institute of Oncology (IOP-GRAACC-UNIFESP). Results: A total of 38 cases of IFD were diagnosed in 818 children with CNS malignancies (4,6%). The mean age was 3.5 years (0.4-28y), with 22 (57.9%) male patients. Embryonal tumors (18/38, 47.3%) were the most prevalent CNS tumors, followed by low-grade gliomas (13/38, 34.2%). All episodes met the EORTC IFD criteria, and 36/38 (94.7%) were proven. Invasive yeast infections (33/36, 91.6%), predominantly Conclusion: Routine systemic antifungal prophylaxis based solely on diagnosis is not recommended for low-risk cases. Evaluating patient- and treatment-specific risk factors is crucial in infants undergoing high-dose chemotherapy with expected neutropenia and in patients requiring prolonged corticosteroid therapy alongside neurosurgical procedures.
Language	English
Publishing date	2023-10-27
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2023.1248082
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Article: Risk Factors Related to Poor Outcomes in the Treatment of Non-conventional Periprosthetic Infection.

Viola, Dan Carai Maia / Rodrigues Neto, Henrique Ribeiro / Garcia, Jairo Greco / Petrilli, Marcelo de Toledo / Carlesse, Fabianne Altruda de Moraes Costa / Jesus-Garcia Filho, Reynaldo

Revista brasileira de ortopedia

2021 Volume 56, Issue 5, Page(s) 615–620

Abstract: ... ...

Abstract	Objectives
Language	English
Publishing date	2021-10-28
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2411301-3
ISSN	1982-4378 ; 0102-3616
ISSN (online)	1982-4378
ISSN	0102-3616
DOI	10.1055/s-0041-1731354
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Article ; Online: How different is invasive fusariosis in pediatric patients than in adults? A systematic review.

Rossato, Luana / Carlesse, Fabianne / Nobrega de Almeida, João / Kontoyiannis, Dimitrios P / Colombo, Arnaldo Lopes

Current opinion in infectious diseases

2021 Volume 34, Issue 6, Page(s) 619–626

Abstract: Purpose of review: To investigate the peculiarities of invasive fusariosis (IF) in pediatric patients.: Methods: We conducted a systematic literature review to identify human cases of locally invasive and systemic fusariosis documented in children ( ... ...

Abstract	Purpose of review: To investigate the peculiarities of invasive fusariosis (IF) in pediatric patients. Methods: We conducted a systematic literature review to identify human cases of locally invasive and systemic fusariosis documented in children (up to 18 years) published between 1973 (first case report) and 2021. Recent findings: One hundred and six cases were retrieved, and hematologic malignancy was reported in 64% (68/106) of the cases. The most frequent anatomic sites involved were skin 66% (70/106), blood 47% (50/106), and lungs 35% (37/106), bone and joint (8%, 09/106), and eye/central nervous system involvement (8%, 9/106). Fusarium solani, followed by Fusarium oxysporum, were the most commonly reported species. In disseminated fusariosis, relapsed or refractory baseline disease (P < 0.001, OR=10.555, CI 95% 3.552-31.365) was associated with poor outcome, whereas voriconazole-based therapy was associated with better prognosis (P = 0.04, OR = 0.273, CI 95% 0.076-0.978). Summary: Hematologic malignancies and solid tumors requiring intensive immunosuppression are the main conditions related to IF in children where other organs than skin, blood, and lungs were frequently involved. Voriconazole therapy appears to be also effective in children with IF, despite the wide pharmacokinetic variability of this triazole in pediatric patients.
MeSH term(s)	Adult ; Antifungal Agents/therapeutic use ; Child ; Fusariosis/diagnosis ; Fusariosis/drug therapy ; Hematologic Neoplasms ; Humans ; Triazoles ; Voriconazole/therapeutic use
Chemical Substances	Antifungal Agents ; Triazoles ; Voriconazole (JFU09I87TR)
Language	English
Publishing date	2021-10-28
Publishing country	United States
Document type	Case Reports ; Journal Article ; Research Support, Non-U.S. Gov't ; Systematic Review
ZDB-ID	645085-4
ISSN	1473-6527 ; 1535-3877 ; 0951-7375 ; 1355-834X
ISSN (online)	1473-6527 ; 1535-3877
ISSN	0951-7375 ; 1355-834X
DOI	10.1097/QCO.0000000000000776
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Zs.A 2462: Show issues

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Article ; Online: Antibiotic prophylaxis in acute childhood leukemia: What is known so far?

Dufrayer, Mauro Cesar / Monteiro, Yasmine Massaro Carneiro / Carlesse, Fabianne Altruda de Moraes Costa / Motta, Fabrizio / Daudt, Liane Esteves / Michalowski, Mariana Bohns

Hematology, transfusion and cell therapy

2022 Volume 45, Issue 4, Page(s) 473–482

Abstract: Introduction: The treatment of acute lymphoblastic leukemia (ALL) has evolved in recent decades, reaching an overall survival rate close to 90%. Currently, approximately 4% of patients with ALL die from secondary complications of chemotherapy. Among ... ...

Abstract	Introduction: The treatment of acute lymphoblastic leukemia (ALL) has evolved in recent decades, reaching an overall survival rate close to 90%. Currently, approximately 4% of patients with ALL die from secondary complications of chemotherapy. Among these complications, the most frequent is febrile neutropenia (FN). The treatment of acute myeloid leukemias (AMLs) is even more aggressive, being consequently related to a considerable amount of treatment-related toxicity with a high risk of severe infection and death. Method: In order to reduce the infection-related risks in these groups of patients, systemic antibacterial prophylaxis has emerged as a possible approach. Results: Antibiotic prophylaxis during neutropenia periods in those undergoing chemotherapy have .already been proven in adults with acute leukemias (ALs). Among the possible available therapeutic options for bacterial prophylaxis in children with cancer, fluoroquinolones emerged with the most amount of evidence. Within this class, levofloxacin became the best choice. Conclusion: Therefore, the use of levofloxacin seems to be indicated in very specific situations: in children who are known to be neutropenic for a long time, secondary to intensive chemotherapy; in children with AL undergoing chemotherapy to induce remission; or in children undergoing hematopoietic stem cell transplantation (HSCT). This article aims to describe recent evidence focusing on antibiotic prophylaxis in children with ALs.
Language	English
Publishing date	2022-11-21
Publishing country	Brazil
Document type	Journal Article ; Review
ISSN	2531-1387
ISSN (online)	2531-1387
DOI	10.1016/j.htct.2022.09.1279
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Article ; Online: A surveillance program for long-term central venous access-associated infections in outpatient chemotherapy services.

Freire, Maristela P / Assis, Denise Brandão / Carlesse, Fabianne / Belizario, Juliana De Cassia / Germano, Priscila Costa Pimentel / Virolli, Juliana Monteiro / Turdo, Anna Claudia / Rodrigues, Beatriz Quental / Maciel, Amanda Luiz Pires / Goncalves, Priscila / Boszczowski, Icaro / Abdala, Edson / Levin, Anna S

Infection control and hospital epidemiology

2023 Volume 44, Issue 10, Page(s) 1555–1561

Abstract: Objective: In this study, we described the first results of a surveillance system for infections associated with long-term central venous catheters (LT-CVC) in patients under outpatient chemotherapy.: Design: This was a multicentric, prospective ... ...

Abstract	Objective: In this study, we described the first results of a surveillance system for infections associated with long-term central venous catheters (LT-CVC) in patients under outpatient chemotherapy. Design: This was a multicentric, prospective study. Setting: Outpatient chemotherapy services. Participants: The study included 8 referral cancer centers in the State of São Paulo. Intervention: These services were invited to participate in a newly created surveillance program for patients under chemotherapy. Several meetings were convened to share previous experiences on LT-CVC infection surveillance and to define the surveillance method. Once the program was implemented, all bloodstream infection (LT-CVC BSIs), tunnel infection, and exit-site infections associated with LT-CVC were reported. Data from January to May 2021 were analyzed. The median monthly number of chemotherapy sessions per clinic was 925 (IQR, 270-5,855). We used Poisson regression to analyze the association of rates with the characteristics of the services. Results: In total, 107 LT-CVC infections were reported, of which 95% were BSIs, mostly associated with totally implantable devices (76%). Infections occurred a median of 4 days after the last catheter manipulation and 116 after the LT-CVC insertion. Also, 102 microorganisms were isolated from LT-CVC BSIs; the most common pathogen was Staphylococcus epidermidis, at 22%. Moreover, 44 infections (44%) fulfilled the criteria for CVC-related LT-CVC BSI and 27 infections (27%) met the criteria for mucosal barrier injury. The 1-year cumulative LT-CVC BSI rate was 1.94 per 1,000 CVC days of use. The rates were higher in public hospitals (IRR, 6.00; P < .001) and in hospitals that already had in place surveillance for LT-CVC infections (IRR, 2.01; P < .01). Conclusion: Our study describes an applicable surveillance method for infections in cancer outpatients using LT-CVC.
MeSH term(s)	Humans ; Brazil/epidemiology ; Catheter-Related Infections/epidemiology ; Catheter-Related Infections/etiology ; Catheterization, Central Venous/adverse effects ; Central Venous Catheters/adverse effects ; Outpatients ; Prospective Studies ; Sepsis/etiology
Language	English
Publishing date	2023-04-11
Publishing country	United States
Document type	Journal Article ; Multicenter Study
ZDB-ID	639378-0
ISSN	1559-6834 ; 0195-9417 ; 0899-823X
ISSN (online)	1559-6834
ISSN	0195-9417 ; 0899-823X
DOI	10.1017/ice.2023.13
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Zs.A 1714: Show issues

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Article ; Online: Safety of levofloxacin as an antibiotic prophylaxis in the induction phase of children newly diagnosed with acute lymphoblastic leukemia: an interim analysis of a randomized, open-label trial in Brazil.

Dufrayer, Mauro Cesar / Rechenmacher, Ciliana / Meneses, Clarice Franco / Monteiro, Yasmine Massaro Carneiro / Carlesse, Fabianne Altruda de Moraes Costa / Motta, Fabrizio / Daudt, Liane Esteves / Michalowski, Mariana Bohns

The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases

2023 Volume 27, Issue 2, Page(s) 102745

Abstract: Background: Despite high cure rates, treatment-related mortality in children with acute lymphoblastic leukemia (ALL) remains significant. About 4% of patients die during remission induction therapy and approximately two-thirds of treatment-related ... ...

Abstract	Background: Despite high cure rates, treatment-related mortality in children with acute lymphoblastic leukemia (ALL) remains significant. About 4% of patients die during remission induction therapy and approximately two-thirds of treatment-related deaths are due to infectious complications. Methods: From May 2021 to June 2022, children aged one through 18 years, with a recent diagnosis of ALL, admitted to three pediatric oncology centers in Brazil, were enrolled in this multicenter, open-label, randomized, phase 3 clinical trial. Eligible patients were randomly divided into two groups, based on a 1:1 allocation ratio, to receive, or not, levofloxacin as a prophylactic agent during the induction phase. All patients were treated according to the IC-BFM 2009 chemotherapy protocol. Primary endpoints were carbapenemase-producing Enterobacteriaceae (CPE) colonization, Clostridioides difficile diarrhea, and other adverse events related to the use of levofloxacin. The secondary endpoint was febrile neutropenia during induction. The median follow-up was 289 days. Results: Twenty patients were included in this trial, 10 in each group (control and levofloxacin). Mild adverse reactions related to levofloxacin were observed in three patients (30%). Three patients had Clostridioides difficile diarrhea, two in the levofloxacin group and one in the control group (p > 0.99). Only one patient presented colonization by CPE. This patient belonged to the levofloxacin group (p > 0.99). Nine patients presented febrile neutropenia, five in the control group and four in the levofloxacin intervention group (p > 0.99), one patient died due to febrile neutropenia. Conclusion: The use of levofloxacin was shown to be safe in the induction phase in children with de novo ALL. The use of this medication did not increase the rate of colonization by CPE nor the rate of diarrhea by C. difficile. All adverse reactions were mild and remitted either spontaneously or after switching medicine administration from oral to intravenous route.
MeSH term(s)	Humans ; Child ; Adolescent ; Levofloxacin/adverse effects ; Antibiotic Prophylaxis/methods ; Anti-Bacterial Agents/adverse effects ; Clostridioides difficile ; Brazil ; Febrile Neutropenia/drug therapy ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications ; Diarrhea/complications ; Diarrhea/drug therapy
Chemical Substances	Levofloxacin (6GNT3Y5LMF) ; Anti-Bacterial Agents
Language	English
Publishing date	2023-02-05
Publishing country	Brazil
Document type	Randomized Controlled Trial ; Multicenter Study ; Clinical Trial, Phase III ; Journal Article
ZDB-ID	2041400-6
ISSN	1678-4391 ; 1413-8670
ISSN (online)	1678-4391
ISSN	1413-8670
DOI	10.1016/j.bjid.2023.102745
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