# Opportunistic Fungi in Cancer and Hematopoietic Stem-Cell Transplant Patients: Diagnosis and Management Strategies
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Therapeutic Strategies: Prevention of Fungal Infections
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Environmental Issues

Nosocomial Aspergillus infections result primarily from inhalation of fungal conidia. Hospital areas undergoing construction or renovation have been associated with an increased risk for nosocomial aspergillosis59,60; patients should be kept from these areas. Rooms for high-risk patients should be equipped with high-efficiency particulate air (HEPA) filters, high rates of air exchange(>12 air changes/hour), and positive pressure so that air from the patient's room flows into the hallway. 57

Although most cases of invasive candidiasis are caused by endogenous Candida organisms colonizing the gastrointestinal tract, Candida species can be carried on the hands of health-care workers, who need to follow appropriate hand-washing precautions to prevent the nosocomial spread of organisms.61 Although the recent CDC guidelines did not specifically address contamination of food and water by fungi, a number of publications suggest that certain foods, plants, and the hospital water supply can be contaminated with Aspergillus and other fungi.62,63 For this reason, patients at high risk for infections caused by these organisms should, where possible, receive food that has been appropriately decontaminated and should avoid activities involving high exposures (eg, gardening). It may be appropriate to avoid aerosols of water that might occur with showering during the highest-risk periods.

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Therapeutic Strategies: Prevention of Fungal Infections
   Environmental Issues
   Choice of Antifungal Agent
   Resistance Concerns
   Enhancing Host Defenses

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Course Number: V035D

This CME Expires on July 1, 2005; no tests will be accepted after this date.

This course is accredited by The University of Pittsburgh School of Medicine, Center for Continuing Education and The International Immunocompromised Host Society

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