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SHR Neuro Cancer Cardio Lipid Metab Microb

Seidel, D; Pana, ZD; Ebrahimi-Fakhari, D; Butzer, SK; Mehler, K; Reinhold, I; Simon, A; Dohna-Schwake, C; Mack, I; Bodmer, N; Niehues, T; Claviez, A; Längler, A; Leipold, A; Prokop, A; Brummel, B; Winkler, B; Gruhn, B; Classen, CF; Friedrich, C; Koenig, C; Flotho, C; Poyer, F; Schilling, F; Calaminus, G; Sieben, G; Schwabe, GC; Reinhard, H; Teltschik, HM; Hengartner, H; Stursberg, J; Greiner, J; Greil, J; Leyh, J; Kühl, JS; Ehlert, K; Bochennek, K; Rohde, M; Demmert, M; Stiefel, M; Eyrich, M; Siepermann, M; Frühwald, M; Döring, M; Nathrath, M; Minkov, M; Streiter, M; Jones, N; Naumann-Bartsch, N; Jorch, N; Beck, O; Beier, R; Crazzolara, R; Kietz, S; Vieth, S; Fröhling, S; Lobitz, S; Ghosh, S; Vallée, TC; Müller, T; Wiesel, T; Däbritz, T; Kontny, U; Thiel, U; Strenger, V; Eberl, WR; Cornely, OA; Groll, AH; Lehrnbecher, T.
Approaches to Invasive Fungal Diseases in Paediatric Cancer Centres: An Analysis of Current Practices and Challenges in Germany, Austria and Switzerland.
Mycoses. 2025; 68(6):e70074 Doi: 10.1111/myc.70074 [OPEN ACCESS]
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Co-authors Med Uni Graz

Strenger Volker

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Abstract:

BACKGROUND: Invasive fungal diseases (IFD) pose significant challenges in paediatric oncology. Their management is complicated by limited paediatric-specific evidence, lack of standardised protocols and variability in resources across centres. This study assessed current practices and addressed the challenges in the prevention, diagnosis and treatment of IFDs in paediatric oncology centres across Germany, Austria and Switzerland. METHODS: A questionnaire was distributed to senior paediatric oncologists in 70 paediatric oncology centres across Germany, Austria and Switzerland, gathering data on centre infrastructure, infectious disease (ID) expertise, annual cumulative IFD incidence in 2023, diagnostic tools, antifungal prophylaxis, treatment and follow-up practices for IFD. Responses were analysed descriptively. RESULTS: Sixty-two centres responded, with a median of 56 (IQR 40-75) new oncological diagnoses per centre; 54.8% of centres managed allogeneic HCT patients. IFDs were reported in 88.7% of centres, with a median cumulative IFD incidence of 4.6% (IQR 3.0%-5.9%). No significant association was found between cumulative IFD incidence and the number of transplants, antifungal prophylaxis protocols and availability of ID consultation services. ID consultation was available in 58.1% of centres, with 24/7 support provided in 41.7% of these centres. Larger centres more frequently had paediatric ID specialists, ID consultation services and access to therapeutic drug monitoring. CONCLUSIONS: The observed heterogeneity in mycology expertise and IFD management strategies across centres reflects the inherent complexity of IFDs and the diagnostic and therapeutic uncertainties amid limited evidence. Strengthening oncology-ID networks and implementing digital consultation platforms may promote high-quality, equitable care, particularly for those with fewer in-house resources.

Find related publications in this database (using NLM MeSH Indexing)

Humans - administration & dosage

Switzerland - epidemiology

Invasive Fungal Infections - diagnosis, epidemiology, drug therapy, prevention & control

Surveys and Questionnaires - administration & dosage

Germany - epidemiology

Austria - epidemiology

Child - administration & dosage

Neoplasms - complications

Antifungal Agents - therapeutic use

Incidence - administration & dosage

Cancer Care Facilities - statistics & numerical data

Find related publications in this database (Keywords)

antifungal stewardship

aspergillosis

cancer

candidaemia

children

diagnosis

management

mycoses

prophylaxis

treatment

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