Strategies to prevent or reduce fungal infection:
The problems associated with diagnosis and treatment of IFI in oncology patients provide the rationale for using preventative strategies. Evidence-based recommendations for preventing exposure to and disease caused by microbial pathogens, including fungi, are detailed in recent joint publications by the Centers for Disease Control and Prevention,
the Infectious Diseases Society of America, and the American Society of Blood and Bone Marrow Transplantation.57,58 Effective prevention of fungal infection is aimed at reducing exposure to fungi, using prophylactic antifungal agents and enhancing the patient's host defenses (Table 5).
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Reduce Exposure to Organisms
Avoid areas of construction or renovationa
Rooms with HEPA filtrationa
Positive air pressure in rooms relative to corridor air pressure
Hand washing
Decontamination or disinfection of food
Avoid food likely to be contaminated with fungi
Avoid water from hospital water system
Avoid high-exposure activities (gardening, construction)
Suppress Growth of Colonizing Organisms
Fluconazoleb
Itraconazoleb
Amphotericin B
Enhance Host Defenses Against Infection
Hematopoietic growth factors (G-CSF, GM-CSF)
Prevent GVHDa
Reduce immunosuppressive drugsa
Use less mucositis producing agentsa
Optimize number of stem cells in hematopoietic grafta
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aRisk factors for infection in multivariable models.
bDecreased infection in randomized trials.
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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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