Emergence of opportunistic mould infections in the hematopoietic stem cell transplant patient

Abstract

Infection due to opportunistic moulds is an emerging problem in hematopoietic stem cell recipients. Through the 1990s, the incidence of invasive aspergillosis in allogenic graft recipients climbed steadily, peaking at 10% to 15%. In this decade, other opportunistic mould infections are emerging, including zygomycosis, fusariosis, and scedosporiosis. These epidemiologic changes are likely due to greater or different types of host immune suppression, medical interventions such as antifungal prophylaxis, and more successful treatment of aspergillosis, keeping immunosuppressed patients alive and at risk. The non-Aspergillus moulds generally exhibit variable susceptibility to antifungal agents, and outcomes continue to be disappointing. Thus, prevention of infection becomes a prominent concern in the care of these patients.