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Study: Oncology Nurses Increasingly Concerned about Fungal Infections in Cancer Patients

doi: 10.1097/01.COT.0000388238.51606.8a

Oncology nurses are increasingly concerned about invasive fungal infections in their patients, a new survey from ONS Edge has found. The organization is a for-profit subsidiary of the Oncology Nursing Society.

The main results, as spelled out in a news release, were in three areas:

  • Risk: Participants clearly understood and appreciated the risk of invasive fungal infections for patients who undergo stem cell transplantation and/or high-dose chemotherapy. 70% of the survey respondents said that patients with myelodysplastic syndromes (MDS) who were neutropenic were at high to very high risk for invasive fungal infections, and nearly 80% said that patients with acute myelogenous leukemia who were neutropenic were at high to very high risk. In addition, 66% of respondents said they thought that patients who were stem cell transplant recipients and who developed graft-versus-host-disease were at high to very high risk.
  • Prevention: Oncology nurses in the survey showed that they understand the importance of prophylaxis, with 77% saying that they agreed with the statement, “I am convinced that antifungal prophylaxis is the best approach to managing the risk of developing invasive fungal infection.”
  • Increased Attention/Focus: Also evident was an increased concern or focus on the problem: 68% said they agreed with the statement, “I am increasingly concerned about invasive fungal infections as a complication in my high-risk patients.”

Full details of the survey, which was funded by Merck, and related information are posted at

The sharp rise over the past two decades is due in large part to the immunosuppression experienced by increased number of patients undergoing hematopoietic stem cell transplantation, the report notes.

Such patients are highly susceptible to bacterial and viral infections, including opportunistic infections due to fungi, especially Aspergillus.

The report indicates that patient populations most at risk as identified by evidence-based guidelines include:

  • Those with profound, prolonged neutropenia (low white cell counts).
  • Patients with acute leukemia of MDS.
  • Patients who have undergone allogeneic hematopoietic stem cell transplants (HSCT).
  • Patients with graft-versus-host-disease.
  • Autologous HSCT recipients with mucositis.

The report includes recommendations on how oncology nurses and other healthcare providers can play a major role in preventing and/or minimizing invasive fungal infections in their immunosuppressed patients, including:

  • Understanding how to identify high-risk patients.
  • Recognizing the sources of the infections and the vectors by which they are transmitted.
  • Maintaining a high level of suspicion that any symptoms experienced by patients could be caused by invasive fungal infections.
  • Knowing and applying the established clinical practice guidelines for prevention and treatment.
© 2010 Lippincott Williams & Wilkins, Inc.
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