Changing Epidemiology of Invasive Fungal Disease in Allogeneic Hematopoietic Stem Cell Transplantation
Invasive fungal disease (IFD) is a common cause of morbidity and mortality in patients with hematologic malignancies, especially among those undergoing allogeneic hematopoietic stem cell transplantation (HSCT). The epidemiology of IFD in HSCT patients has been evolving over the last decades, mainly...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-10-01
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| Series: | Journal of Fungi |
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| Online Access: | https://www.mdpi.com/2309-608X/7/10/848 |
| _version_ | 1827679334464225280 |
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| author | Pedro Puerta-Alcalde Carolina Garcia-Vidal |
| author_facet | Pedro Puerta-Alcalde Carolina Garcia-Vidal |
| author_sort | Pedro Puerta-Alcalde |
| collection | DOAJ |
| description | Invasive fungal disease (IFD) is a common cause of morbidity and mortality in patients with hematologic malignancies, especially among those undergoing allogeneic hematopoietic stem cell transplantation (HSCT). The epidemiology of IFD in HSCT patients has been evolving over the last decades, mainly in relation to changes in HSCT therapies such as antifungal prophylaxis. A progressive decrease in <i>Candida albicans</i> infection has been documented, alongside a progressive increase in infections caused by non-<i>albicans</i> <i>Candida</i> species, filamentous fungi, and/or multidrug-resistant fungi. Currently, the most frequent IFD is invasive aspergillosis. In some parts of the world, especially in north Central Europe, a high percentage of <i>Aspergillus fumigatus</i> isolates are azole-resistant. New diagnostic techniques have documented the existence of cryptic <i>Aspergillus</i> species with specific characteristics. An increase in mucormycosis and fusariosis diagnoses, as well as diagnoses of other rare fungi, have also been described. IFD epidemiology is likely to continue changing further due to both an increased use of mold-active antifungals and a lengthened survival of patients with HSCT that may result in hosts with weaker immune systems. Improvements in microbiology laboratories and the widespread use of molecular diagnostic tools will facilitate more precise descriptions of current IFD epidemiology. Additionally, rising resistance to antifungal drugs poses a major threat. In this scenario, knowledge of current epidemiology and accurate IFD diagnoses are mandatory in order to establish correct prophylaxis guidelines and appropriate early treatments. |
| first_indexed | 2024-03-10T06:28:08Z |
| format | Article |
| id | doaj.art-a666b6d88d8840bebfddac36608148c2 |
| institution | Directory Open Access Journal |
| issn | 2309-608X |
| language | English |
| last_indexed | 2024-03-10T06:28:08Z |
| publishDate | 2021-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Fungi |
| spelling | doaj.art-a666b6d88d8840bebfddac36608148c22023-11-22T18:47:27ZengMDPI AGJournal of Fungi2309-608X2021-10-0171084810.3390/jof7100848Changing Epidemiology of Invasive Fungal Disease in Allogeneic Hematopoietic Stem Cell TransplantationPedro Puerta-Alcalde0Carolina Garcia-Vidal1Department of Infectious Diseases, Hospital Clinic of Barcelona, C/Villarroel 170, 08036 Barcelona, SpainDepartment of Infectious Diseases, Hospital Clinic of Barcelona, C/Villarroel 170, 08036 Barcelona, SpainInvasive fungal disease (IFD) is a common cause of morbidity and mortality in patients with hematologic malignancies, especially among those undergoing allogeneic hematopoietic stem cell transplantation (HSCT). The epidemiology of IFD in HSCT patients has been evolving over the last decades, mainly in relation to changes in HSCT therapies such as antifungal prophylaxis. A progressive decrease in <i>Candida albicans</i> infection has been documented, alongside a progressive increase in infections caused by non-<i>albicans</i> <i>Candida</i> species, filamentous fungi, and/or multidrug-resistant fungi. Currently, the most frequent IFD is invasive aspergillosis. In some parts of the world, especially in north Central Europe, a high percentage of <i>Aspergillus fumigatus</i> isolates are azole-resistant. New diagnostic techniques have documented the existence of cryptic <i>Aspergillus</i> species with specific characteristics. An increase in mucormycosis and fusariosis diagnoses, as well as diagnoses of other rare fungi, have also been described. IFD epidemiology is likely to continue changing further due to both an increased use of mold-active antifungals and a lengthened survival of patients with HSCT that may result in hosts with weaker immune systems. Improvements in microbiology laboratories and the widespread use of molecular diagnostic tools will facilitate more precise descriptions of current IFD epidemiology. Additionally, rising resistance to antifungal drugs poses a major threat. In this scenario, knowledge of current epidemiology and accurate IFD diagnoses are mandatory in order to establish correct prophylaxis guidelines and appropriate early treatments.https://www.mdpi.com/2309-608X/7/10/848antifungalfungal infectionimmunosuppressioninvasive fungal diseasemoldsmortality |
| spellingShingle | Pedro Puerta-Alcalde Carolina Garcia-Vidal Changing Epidemiology of Invasive Fungal Disease in Allogeneic Hematopoietic Stem Cell Transplantation Journal of Fungi antifungal fungal infection immunosuppression invasive fungal disease molds mortality |
| title | Changing Epidemiology of Invasive Fungal Disease in Allogeneic Hematopoietic Stem Cell Transplantation |
| title_full | Changing Epidemiology of Invasive Fungal Disease in Allogeneic Hematopoietic Stem Cell Transplantation |
| title_fullStr | Changing Epidemiology of Invasive Fungal Disease in Allogeneic Hematopoietic Stem Cell Transplantation |
| title_full_unstemmed | Changing Epidemiology of Invasive Fungal Disease in Allogeneic Hematopoietic Stem Cell Transplantation |
| title_short | Changing Epidemiology of Invasive Fungal Disease in Allogeneic Hematopoietic Stem Cell Transplantation |
| title_sort | changing epidemiology of invasive fungal disease in allogeneic hematopoietic stem cell transplantation |
| topic | antifungal fungal infection immunosuppression invasive fungal disease molds mortality |
| url | https://www.mdpi.com/2309-608X/7/10/848 |
| work_keys_str_mv | AT pedropuertaalcalde changingepidemiologyofinvasivefungaldiseaseinallogeneichematopoieticstemcelltransplantation AT carolinagarciavidal changingepidemiologyofinvasivefungaldiseaseinallogeneichematopoieticstemcelltransplantation |