ABSTRACT
The European Confederation of Medical Mycology (ECMM), formed due to the surge in invasive fungal infections (IFI), initiated the Excellence Centers program in 2016 to guide stakeholders to leading medical mycology sites. This report focuses on the Cologne ECMM Excellence Center, recognized with Diamond status for active global involvement in 2017. The center offers free consultation via email and phone, responding within 24 h for life-threatening IFI, collecting data on origin, pathogens, infection details, and more. Over two years, 189 requests were received globally, predominantly from Germany (85%), mainly involving Aspergillus spp., Mucorales, and Candida spp. Fungal mixed infections occurred in 4% of cases. The center's service effectively addresses IFI challenges, advocating for a comprehensive study encompassing all ECMM Excellence Centers to enhance global mycological care. Proactive expansion of consultancy platforms is crucial, with future analyses needed to assess expert advice's impact on patient outcomes.
Subject(s)
Invasive Fungal Infections , Mycoses , Humans , Mycology , Invasive Fungal Infections/diagnosis , Invasive Fungal Infections/drug therapy , Mycoses/drug therapy , Aspergillus , Referral and Consultation , Antifungal Agents/therapeutic useABSTRACT
Infections represent one of the most frequent complications during therapy of acute myeloid leukemia (AML). In addition to associated prolonged phases of neutropenia, damage to the mucosal barrier by cytotoxic agents favors infections caused by endogenous pathogens. The source often remains unknown with bacteremia being the most common evidence of infection. Infections with gram-positive bacteria predominate, however, infections with gram-negative bacteria more often lead to sepsis and death. Due to prolonged neutropenia, patients with AML are furthermore at risk for invasive fungal infections. Viruses, on the other hand, are rarely the cause of neutropenic fever. Because of the limited inflammatory response in neutropenic patients, fever is often the only sign of infection and therefore always represents a hematologic emergency. Prompt diagnosis and initiation of an adequate anti-infective therapy are critical to avoid progression to sepsis and possibly death.
Subject(s)
Bacteremia , Leukemia, Myeloid, Acute , Neutropenia , Sepsis , Humans , Leukemia, Myeloid, Acute/complications , Leukemia, Myeloid, Acute/drug therapy , Fever/etiology , Sepsis/diagnosis , Sepsis/complications , Neutropenia/complicationsABSTRACT
We approached European tertiary care institutions to provide details regarding their management of the current human monkeypox outbreak. 73 out of 105 sites stated to have capacities to manage the outbreak adequately amid the ongoing coronavirus disease 2019 pandemic. There are effective protective measures to prevent nosocomial infections in place at nearly all institutions. Diagnostic and treatment capacities on the other hand have potential to be improved.
