Infection Control to Reduce Invasive Fungal Infections

Substantial progress in diagnostic and therapeutic medical procedures over the past century has helped increase longevity in the industrialized world. Progress in oncological treatment options, successful human organ as well as hematopoietic stem cell transplantation can be counted as some of the biggest achievements of modern medicine. With the development of more effective immunosuppressive drugs, organ transplants have become an accepted treatment for a growing number of otherwise incurable diseases. Longer survival of transplant recipients has at the same time greatly increased the number of immunocompromised patients. These patients are typically at greater risk of acquiring infections caused by the so-called opportunistic organisms such as fungi, whose virulence is low in immunocompetent patients. The types of fungal infection occurring in susceptible patients depend not only on the host’s underlying disease, i.e. their net state of immuno-suppression but also on their epidemiological exposure and/or colonization with opportunistic fungi. The prevention of endogenous as well as exogenous invasive fungal infections in susceptible patient groups therefore necessitates a combination of antifungal stewardship with environmental infection control strategies.