Breakthrough invasive fungal infections: Who is at risk?

Mycoses. 2020 Oct;63(10):1021-1032. doi: 10.1111/myc.13148. Epub 2020 Sep 4.

Abstract

The epidemiology of invasive fungal infections (IFIs) in immunocompromised individuals has changed over the last few decades, partially due to the increased use of antifungal agents to prevent IFIs. Although this strategy has resulted in an overall reduction in IFIs, a subset of patients develop breakthrough IFIs with substantial morbidity and mortality in this population. Here, we review the most significant risk factors for breakthrough IFIs in haematology patients, solid organ transplant recipients, and patients in the intensive care unit, focusing particularly on host factors, and highlight areas that require future investigation.

Keywords: breakthrough fungal infections; fungal infections; risk factors.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / adverse effects
  • Antifungal Agents / therapeutic use
  • Aspergillus / isolation & purification
  • Aspergillus / pathogenicity
  • Candida / isolation & purification
  • Candida / pathogenicity
  • Central Venous Catheters / adverse effects
  • Central Venous Catheters / microbiology
  • Echinocandins / therapeutic use
  • Fluconazole / therapeutic use
  • Fusarium / isolation & purification
  • Fusarium / pathogenicity
  • Genetic Predisposition to Disease
  • Hematologic Neoplasms / complications
  • Humans
  • Immunocompromised Host
  • Intensive Care Units
  • Invasive Fungal Infections* / diagnosis
  • Invasive Fungal Infections* / drug therapy
  • Invasive Fungal Infections* / epidemiology
  • Invasive Fungal Infections* / prevention & control
  • Mucorales / isolation & purification
  • Mucorales / pathogenicity
  • Mycoses / diagnosis
  • Mycoses / drug therapy
  • Mycoses / epidemiology
  • Mycoses / prevention & control
  • Neutropenia / complications
  • Opportunistic Infections / drug therapy
  • Opportunistic Infections / epidemiology
  • Opportunistic Infections / microbiology
  • Opportunistic Infections / prevention & control
  • Organ Transplantation / adverse effects
  • Penicillium / isolation & purification
  • Penicillium / pathogenicity
  • Risk Factors
  • Triazoles / therapeutic use

Substances

  • Adrenal Cortex Hormones
  • Antifungal Agents
  • Echinocandins
  • Triazoles
  • Fluconazole