Approaches to Invasive Fungal Diseases in Paediatric Cancer Centres: An Analysis of Current Practices and Challenges in Germany, Austria and Switzerland

Seidel D, Pana ZD, Ebrahimi-Fakhari D, Butzer SK, Mehler K, Reinhold I, Simon A, Dohna-Schwake C, Mack I, Bodmer N, Niehues T, Claviez A, Längler A, Leipold A, Prokop A, Brummel B, Winkler B, Gruhn B, Classen CF, Friedrich C, Koenig C, Flotho C, Poyer F, Schilling F, Calaminus G, Sieben G, Schwabe GC, Reinhard H, Teltschik HM, Hengartner H, Stursberg J, Greiner J, Greil J, Leyh J, Kühl JS, Ehlert K, Bochennek K, Rohde M, Demmert M, Stiefel M, Eyrich M, Siepermann M, Frühwald M, Döring M, Nathrath M, Minkov M, Streiter M, Jones N, Naumann-Bartsch N, Jorch N, Beck O, Beier R, Crazzolara R, Kietz S, Vieth S, Fröhling S, Lobitz S, Ghosh S, Vallée TC, Müller T, Wiesel T, Däbritz T, Kontny U, Thiel U, Strenger V, Eberl WR, Cornely OA, Groll AH, Lehrnbecher T (2025)

Publication Type: Journal article

Publication year: 2025

Journal

Book Volume: 68

Article Number: e70074

Journal Issue: 6

DOI: 10.1111/myc.70074

Abstract

Background: Invasive fungal diseases (IFD) pose significant challenges in paediatric oncology. Their management is complicated by limited paediatric-specific evidence, lack of standardised protocols and variability in resources across centres. This study assessed current practices and addressed the challenges in the prevention, diagnosis and treatment of IFDs in paediatric oncology centres across Germany, Austria and Switzerland. Methods: A questionnaire was distributed to senior paediatric oncologists in 70 paediatric oncology centres across Germany, Austria and Switzerland, gathering data on centre infrastructure, infectious disease (ID) expertise, annual cumulative IFD incidence in 2023, diagnostic tools, antifungal prophylaxis, treatment and follow-up practices for IFD. Responses were analysed descriptively. Results: Sixty-two centres responded, with a median of 56 (IQR 40–75) new oncological diagnoses per centre; 54.8% of centres managed allogeneic HCT patients. IFDs were reported in 88.7% of centres, with a median cumulative IFD incidence of 4.6% (IQR 3.0%–5.9%). No significant association was found between cumulative IFD incidence and the number of transplants, antifungal prophylaxis protocols and availability of ID consultation services. ID consultation was available in 58.1% of centres, with 24/7 support provided in 41.7% of these centres. Larger centres more frequently had paediatric ID specialists, ID consultation services and access to therapeutic drug monitoring. Conclusions: The observed heterogeneity in mycology expertise and IFD management strategies across centres reflects the inherent complexity of IFDs and the diagnostic and therapeutic uncertainties amid limited evidence. Strengthening oncology-ID networks and implementing digital consultation platforms may promote high-quality, equitable care, particularly for those with fewer in-house resources.

Involved external institutions

Universitätsklinikum Köln Germany (DE) University of Nicosia Cyprus (CY) Universitätsklinikum Münster Germany (DE) Universitätsklinikum des Saarlandes (UKS) Germany (DE) Universitätsklinikum Essen Germany (DE) Universitäts-Kinderspital beider Basel (UKBB) Switzerland (CH) Universitäts-Kinderspital Zürich Switzerland (CH) Medical University Lausitz - Carl Thiem (MUL - CT) Germany (DE) Asklepios Kinderklinik Sankt Augustin Germany (DE) Klinikum Stuttgart Germany (DE) Kantonsspital St.Gallen Switzerland (CH) Universitätsklinikum Ulm Germany (DE) Kantonsspital Aarau AG Switzerland (CH) Universitätsklinikum Heidelberg Germany (DE) Cnopf'sche Kinderklinik Germany (DE) Universität Leipzig Germany (DE) Universitätsmedizin Greifswald / Universitätsklinikum Greifswald Germany (DE) Goethe-Universität Frankfurt am Main Germany (DE) Universitätsklinikum Gießen und Marburg (UKGM) Germany (DE) Universitätsklinikum Schleswig-Holstein (UKSH) Germany (DE) Universitätsklinikum Augsburg Germany (DE) Universitätsklinikum Tübingen Germany (DE) Technische Universität München (TUM) Germany (DE) Johannes Kepler Universität (JKU) Linz Austria (AT) Evangelisches Klinikum Bethel Germany (DE) Universitätsmedizin der Johannes Gutenberg-Universität Mainz Germany (DE) Universität Regensburg Germany (DE) Klinikum Bremen-Mitte Germany (DE) Gemeinschaftsklinikum Mittelrhein Germany (DE) Universitätsklinikum Düsseldorf Germany (DE) Klinikum der Universität München Germany (DE) Charité - Universitätsmedizin Berlin Germany (DE) Universität Witten/Herdecke Germany (DE) Universitätsklinikum Carl Gustav Carus Dresden Germany (DE) Universitätsklinikum Aachen (UKA) Germany (DE) Medizinische Universität Graz Austria (AT) Städtisches Klinikum Braunschweig Germany (DE) HELIOS Kliniken Germany (DE) Universitätsklinikum Magdeburg A.ö.R. Germany (DE) Gemeinschaftskrankenhaus Herdecke Germany (DE) Städtisches Klinikum Karlsruhe Germany (DE) Klinikum Dortmund Germany (DE) Universitätsklinikum Hamburg-Eppendorf (UKE) Germany (DE) Universitätsklinikum Jena Germany (DE) Universitätsmedizin Rostock Germany (DE) Carl von Ossietzky Universität Oldenburg Germany (DE) Inselspital, Universitätsspital Bern Switzerland (CH) Universitätsklinikum Freiburg Germany (DE) Medizinische Universität Wien Austria (AT) Luzerner Kantonsspital (LUKS) Switzerland (CH) Universitätsklinikum Bonn Germany (DE) Universitätsklinikum Mannheim Germany (DE) Martin-Luther-Universität Halle-Wittenberg (MLU) Germany (DE) Universitätsklinikum Würzburg Germany (DE) Medizinische Hochschule Hannover (MHH) / Hannover Medical School Germany (DE) Medizinische Universität Innsbruck Austria (AT) Kliniken der Stadt Köln Germany (DE)

How to cite

APA:

Seidel, D., Pana, Z.D., Ebrahimi-Fakhari, D., Butzer, S.K., Mehler, K., Reinhold, I.,... Lehrnbecher, T. (2025). Approaches to Invasive Fungal Diseases in Paediatric Cancer Centres: An Analysis of Current Practices and Challenges in Germany, Austria and Switzerland. Mycoses, 68(6). https://doi.org/10.1111/myc.70074

MLA:

Seidel, Danila, et al. "Approaches to Invasive Fungal Diseases in Paediatric Cancer Centres: An Analysis of Current Practices and Challenges in Germany, Austria and Switzerland." Mycoses 68.6 (2025).

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