Epidemiology and Disease Burden of Hospitalised Children With Invasive Fungal Infection in China, 2016-2022.

AIMS/

BACKGROUND

Invasive fungal infection (IFI) represents a significant global health challenge, particularly in paediatric populations, due to high mortality and severe long-term sequelae. This study aimed to characterize the epidemiological patterns and quantify the disease burden of IFI among hospitalised children in China.

METHODS

Data were obtained from the face sheets of discharge medical records collected between 2016 and 2022 from 30 tertiary children's hospitals, aggregated into the FUTang Updating medical REcords (FUTURE) database. Sociodemographic variables, disease spectrum, pathogen distribution, potential risk factors, length of stay (LOS), and overall disease burden among children with IFI were systematically analysed.

RESULTS

A total of 1250 IFI cases were identified, revealing an upward trend in incidence since 2019. The pathogen distribution among the 485 episodes with available microbiological data included Candida (25.36%; 123/485), Aspergillus (23.71%; 115/485), Cryptococcus (22.06%; 107/485), Pneumocystis (21.44%; 104/485), Mucor (4.12%; 20/485), Talaromyces (1.24%; 6/485), Histoplasma (0.82%; 4/485), Blastomyces (0.62%; 3/485), and Sporotrichum (0.62%; 3/485). Disseminated infections accounted for 5.76% (72/1250) of all IFI. Among the 1178 non-disseminated IFI cases, pneumonia (73.34%, 864/1178), central nervous system (CNS) infections (15.53%, 183/1178), and bloodstream infections (8.66%, 102/1178) were the predominant disease types. The most prevalent risk factors were haematological malignancies and myelosuppression. Overall, 181 patients died during their hospitalisation, representing a mortality rate of 14.48%.

CONCLUSION

The incidence of IFI among hospitalised children in tertiary centres in China has risen since 2019, with Candida, Aspergillus, and Cryptococcus identified as the predominant pathogens. These infections are associated with considerable mortality (14.48%). The findings highlight the urgent need for enhanced surveillance, earlier diagnosis, and targeted therapeutic strategies to reduce morbidity and mortality in this high-risk population.