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Approaches to Invasive Fungal Diseases in Paediatric Cancer Centres: An Analysis of Current Practices and Challenges in Germany, Austria and Switzerland

Summary

This research examined how pediatric cancer hospitals in Germany, Austria, and Switzerland manage fungal infections, which are a serious risk for children undergoing cancer treatment. The survey found that while most hospitals have infection specialists and antifungal prevention strategies, there are significant differences in how they diagnose and treat these infections. The study identified key challenges like drug interactions and delays in testing, and suggests that better networks between cancer and infection specialists could improve patient care.

Background

Invasive fungal diseases (IFD) pose significant challenges in pediatric oncology due to limited pediatric-specific evidence, lack of standardized protocols, and variability in resources across centers. Effective management requires early diagnosis and timely appropriate treatment, but real-world application of diagnostic criteria remains challenging with over 40% of pediatric cases falling outside probable or proven categories.

Objective

This study assessed current practices and addressed challenges in the prevention, diagnosis, and treatment of invasive fungal diseases in pediatric oncology centers across Germany, Austria, and Switzerland to identify institutional and regional approaches and provide a starting point for developing future pediatric antifungal stewardship programs.

Results

Sixty-two centers responded with a median of 56 new oncological diagnoses per center; 88.7% reported IFDs with median cumulative incidence of 4.6%. No significant association was found between cumulative IFD incidence and number of transplants, prophylaxis protocols, or ID consultation availability. Larger centers more frequently had pediatric ID specialists and access to therapeutic drug monitoring, with significant heterogeneity in diagnostic capabilities and treatment strategies across centers.

Conclusion

The observed heterogeneity in mycology expertise and IFD management strategies reflects the complexity of IFDs and diagnostic/therapeutic uncertainties amid limited evidence. Strengthening oncology-ID networks and implementing digital consultation platforms may promote high-quality, equitable care, particularly for centers with fewer in-house resources.
  • Published in:Mycoses,
  • Study Type:Survey/Cross-sectional Analysis,
  • Source: PMID: 40515497, DOI: 10.1111/myc.70074
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