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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

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Název: Approaches to Invasive Fungal Diseases in Paediatric Cancer Centres: An Analysis of Current Practices and Challenges in Germany, Austria and Switzerland
Autoři: Seidel, Danila, Pana, Zoi Dorothea, Ebrahimi‐Fakhari, Daniel, Butzer, Sarina K., Mehler, Katrin, Reinhold, Ilana, Simon, Arne, Dohna‐Schwake, Christian, Mack, Ines, Bodmer, Nicole, Niehues, Tim, Claviez, Alexander, Längler, Alfred, Leipold, Alfred, Prokop, Aram, Brummel, Bastian, Winkler, Beate, Gruhn, Bernd, Classen, Carl Friedrich, Friedrich, Carsten, Koenig, Christa, Flotho, Christian, Poyer, Fiona, Schilling, Freimut, Calaminus, Gabriele, Sieben, Geeke, Schwabe, Georg C., Reinhard, Harald, Teltschik, Heiko‐Manuel, Hengartner, Heinz, Stursberg, Jana, Greiner, Jeanette, Greil, Johann, Leyh, Jörg, Kühl, Jörn‐Sven, Ehlert, Karoline, Bochennek, Konrad, Rohde, Marius, Demmert, Martin, Stiefel, Martina, Eyrich, Matthias, Siepermann, Meinolf, Frühwald, Michael, Döring, Michaela, Nathrath, Michaela, Minkov, Milen, Streiter, Monika, Jones, Neil, Naumann‐Bartsch, Nora, Jorch, Norbert
Zdroj: Mycoses ; volume 68, issue 6 ; ISSN 0933-7407 1439-0507
Informace o vydavateli: Wiley
Rok vydání: 2025
Sbírka: Wiley Online Library (Open Access Articles via Crossref)
Popis: 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.
Druh dokumentu: article in journal/newspaper
Jazyk: English
DOI: 10.1111/myc.70074
Dostupnost: https://doi.org/10.1111/myc.70074
https://onlinelibrary.wiley.com/doi/pdf/10.1111/myc.70074
Rights: http://creativecommons.org/licenses/by/4.0/
Přístupové číslo: edsbas.53AFAD3E
Databáze: BASE
Popis
Abstrakt: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.
DOI:10.1111/myc.70074