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Invasive Fungal Infections: A Continuing Challenge Report from the 17th International Symposium on Infections in the Immunocompromised Host, Genoa, Italy, 24–27 July 2012

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Abstract

The management of invasive fungal infections (IFIs) remains a challenge to the most experienced clinicians and mycologists as the therapeutic landscape continues to change. Delegates to the 17th International Symposium on Infections in the Immunocompromised Host heard that fungal epidemiology, patient demographics, diagnosis and treatment are all evolving. Diagnosis-driven therapy—pre-emptive or targeted—is the ideal approach to managing IFIs, but is dependent on reliable biomarker assays to identify, or at least strongly suggest, the organism(s) responsible. Biomarkers, however, are subject to ongoing research and so are also evolving. Some assays also may not be available in a particular centre. The same applies to investigations such as CT-scans and bronchoscopy that need to be performed in a timely fashion to help confirm an IFI. Thus, for patients with febrile neutropenia despite broad-spectrum antibiotic cover, clinicians without the appropriate diagnostic facilities prefer to start antifungal (AF) treatment immediately whilst attempting to confirm the diagnosis. Empirical therapy therefore looks likely to have a role for some time. For high-risk patients, such as those with haematological malignancies and/or undergoing haematopoietic stem cell transplantation (HSCT), the preferred strategy is to prevent IFIs using AF prophylaxis although regular screening with biomarkers is an alternative.

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Notes

  1. European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group

  2. 3rd European Conference on Infections in Leukaemia

  3. Interscience Conference on Antimicrobial Agents and Chemotherapy

  4. Infectious Diseases Society of America

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Disclosure

M. Slavin: grants from Merck, Pfizer and Gilead, payment for lectures from Pfizer and Merck; L. M. Grist: meeting attendance and contribution to the writing of this report was supported by MSD

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Authors and Affiliations

  1. Department of Infectious Diseases, Peter MacCallum Cancer Centre, St Andrew’s Place, East Melbourne, Victoria, Australia, 3002

    Monica A. Slavin

  2. Crowborough, UK

    Liz McNeil Grist

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Correspondence to Monica A. Slavin.

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Slavin, M.A., Grist, L.M. Invasive Fungal Infections: A Continuing Challenge Report from the 17th International Symposium on Infections in the Immunocompromised Host, Genoa, Italy, 24–27 July 2012. Curr Fungal Infect Rep 7, 83–88 (2013). https://doi.org/10.1007/s12281-012-0123-9

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