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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 study examined how 62 children’s cancer hospitals in Germany, Austria and Switzerland manage fungal infections in young cancer patients. Researchers found that hospitals use different methods to prevent and treat these serious infections, with some having special fungal infection experts and others not. The study revealed that larger hospitals tend to have better resources and expertise, while smaller hospitals face challenges like drug interactions and delays in getting test results.

Background

Invasive fungal diseases (IFD) pose significant challenges in paediatric oncology with limited paediatric-specific evidence, lack of standardised protocols and variability in resources across centres. Early diagnosis and timely appropriate treatment are cornerstones of effective management, yet real-world implementation of guidelines remains unclear.

Objective

To assess current practices and identify challenges in prevention, diagnosis and treatment of invasive fungal diseases in paediatric oncology centres across Germany, Austria and Switzerland to provide a framework for developing future antifungal stewardship programmes.

Results

62 centres responded with median 56 new oncological diagnoses per centre and 4.6% cumulative IFD incidence. 58.1% had paediatric ID consultation services with 41.7% providing 24/7 support. No significant association was found between IFD incidence and number of transplants, prophylaxis protocols or ID consultation availability. Heterogeneous practices were observed in antifungal prophylaxis, diagnostic capabilities and treatment strategies.

Conclusion

Significant heterogeneity in mycology expertise and IFD management strategies across centres reflects diagnostic and therapeutic uncertainties. Strengthening oncology-ID networks and implementing digital consultation platforms may promote high-quality, equitable care particularly for centres with fewer in-house resources.
  • Published in:Mycoses,
  • Study Type:Cross-sectional Survey,
  • Source: PMID: 40515497, DOI: 10.1111/myc.70074
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