Invasive fungal infections have become a leading cause of infectious morbidity and mortality in cancer patients. Infection rates are increasing as dose intensity of antineoplastic regimens has increased and better methods to control bacterial infections have been put into practice. Candida species have become the fourth leading bloodstream isolates in hospitalized patients and are the leading fungal pathogens in cancer patients. Today, non-albicans species represent approximately half of Candida blood stream isolates. With the increasing use of azoles, the emergence of azole resistance or selection of azole-resitant Candida species has increased. Aspergillus is the major non-Candida fungal pathogen but other mold pathogens are increasing as well. Changes in antineoplastic treatment regimens, the greater use of indwelling central venous catheters, the introduction of highly immunosuppressive purine analogs, the emphasis on dose intensity and myelosuppressive treatment regimens, and the use of azoles have resulted in changes in the frequency and spectrum of fungal pathogens. There are several strategies widely used to control fungal infections: prophylaxis, empiric therapy, and treatment are appropriate for different settings. New rapid diagnostics may make pre-emptive therapy possible. The introduction of new antifungal agents has allowed clinicians greater latitude in addressing invasive fungal infections. In this session, the changing epidemiology, the problem of emerging drug resistance, treatment strategies, and the use of new antifungal agents will be addressed.
Full conference title:
- ICAAC 41st