Challenges in management of invasive fungal infections in stem cell transplant

Area of Science:

• Infectious Diseases
• Hematology
• Mycology

Background:

• Invasive fungal infections (IFIs) are a major cause of death in hematopoietic stem cell transplant (HSCT) patients.
• Routine antifungal prophylaxis is standard, but evolving resistance patterns and breakthrough infections pose challenges.

Purpose of the Study:

• To review the management of IFIs in HSCT recipients.
• To address the challenges posed by drug-resistant fungal pathogens and breakthrough infections.

Main Methods:

• Literature review of common and rare fungal pathogens in HSCT.
• Discussion of management strategies for yeast and mold infections.
• Exploration of combination therapy and novel antifungal agents.

Main Results:

• Common pathogens include Candida, Aspergillus, and Mucorales.
• Rarer pathogens like Trichosporon, Fusarium, Scedosporium, and Lomentospora exhibit higher resistance.
• Strategies for breakthrough infections and the role of new antifungals are discussed.

Conclusions:

• Effective management of IFIs in HSCT requires addressing drug resistance.
• Further research is needed to fill knowledge gaps in antifungal therapy for HSCT patients.