OncohematologyOncohematologyОнкогематология1818-83462413-4023Publishing House ABV Press10410.17650/1818-8346-2011-6-1-39-44HEMATOLOGIC MALIGNANCIES: DIAGNOSIS, TREATMENT, SUPPORTIVE CAREГЕМОБЛАСТОЗЫ: ДИАГНОСТИКА, ЛЕЧЕНИЕ, СОПРОВОДИТЕЛЬНАЯ ТЕРАПИЯEpidemic outbreak of candidemia caused by unusual types of Candida non-albicans: clinical course patterns and search for the sourceЭпидемическая вспышка кандидемий, вызванных необычными видами Candida non-albicans: закономерности клинического течения и поиски источникаKalininaI. I.КалининаИ. И.
Russian Federation
LitvinovD. V.ЛитвиновД. В.
Russian Federation
VeselovaI. V.ВеселоваИ. В.
Russian Federation
PonomarevaN. I.ПономареваН. И.
Russian Federation
ShelikhovaL. N.ШелиховаЛ. Н.
Russian Federation
FominykhV. V.ФоминыхВ. В.
Russian Federation
KlyasovaG. A.КлясоваГ. А.
Russian Federation
MaschanA. A.МасчанА. А.
Russian Federation
amaschan@mail.ruFederal Research Center of Pediatric Hematology, Oncology and ImmunologyФГУ Федеральный научно-клинический центр детской гематологии, онкологии ФГУ и иммунологии Минздравсоцразвития РоссииRussian Children Clinical HospitalРоссийская детская клиническая больницаFederal Research Center of Pediatric Hematology, Oncology and Immunology Russian Children Clinical HospitalФГУ Федеральный научно-клинический центр детской гематологии, онкологии ФГУ и иммунологии Минздравсоцразвития России Российская детская клиническая больницаHematological Research CenterГематологический научный центр РАМН2402201161394424072014240720142011https://oncohematology.abvpress.ru/ongm/article/view/104

Introduction: Invasive fungal infections (IFI) remain an unresolved issue of hematology/oncology despite the introduction of methods of early diagnostic and invent of new highly active antimycotics. In etiologic structure of IFI the leading role belongs to candidiasis, the most frequent clinical form of which is candidemia. Candidemias in the pediatric hematology/oncology departments usually occur as sporadic cases, and epidemics are very rare. We describe an epidemic outbreak of candidemia caused by species of Candida non-albicans rarely reported in patients.

Results: Ten cases of candidemia were registered in the hematology/oncology department within one month. Candidemia was caused by C. guilliermondi in 4 patients (in 1 concomitantly with C. calliculosa), by С. parapsilosis – in 3 patients and by C. pelliculosa in another 3 patients. Contaminated intravenous 4 % KCl solution has been found to be the source of candidemia. In four patients granulocytes count was < 0.5  109/l at the time of positive blood cultures. Clinical manifestation of candidemia included fever > 38.5 in all patients and lung involvement in 2 patients. All patients received systemic antifungal therapy: 5 — monotherapy, 3 — combinations of 2 drugs and 2 — of 3 drugs. Central venous catheter was removed in 4 patients. Clinical and microbiological cure was achieved in all patients; the mortality rate was 0 %. In 2 patients candidemia relapsed 22 and 60 days after the first episode.

Conclusions: Outbreaks of systemic infections caused by unusual pathogens necessitate searching of a single infection source. Candidemia caused by a direct pathogen inoculation in the bloodstream, in the absence of multiple risk factors for invasive fungal infections follows a favorable course.

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