Evidence map›Paper›PMID 40515497›Full record

ArticleMycoses2025

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

Danila Seidel, Zoi Dorothea Pana, Daniel Ebrahimi-Fakhari, Sarina K Butzer, Katrin Mehler, Ilana Reinhold, Arne Simon, Christian Dohna-Schwake, Ines Mack, Nicole Bodmer and 59 more

Abstract read
In one paragraph

Article in Mycoses, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

69 authors.

Danila SeidelInstitute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.ORCID https://orcid.org/0000-0003-4388-3117
Zoi Dorothea PanaMedical School, University of Nicosia (UNIC), Nicosia, Cyprus.ORCID https://orcid.org/0000-0002-5893-1081
Daniel Ebrahimi-FakhariInfectious Disease Research Program, Center for Bone Marrow Transplantation and Dept. of Pediatric Hematology/Oncology, University Children's Hospital Münster, Münster, Germany.ORCID https://orcid.org/0000-0002-3097-141X
Sarina K ButzerDivision of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.ORCID https://orcid.org/0000-0002-4812-9220
Katrin MehlerDivision of Pediatric Infectious Diseases, Department of Pediatrics, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.ORCID https://orcid.org/0000-0002-3052-2147
Ilana ReinholdInstitute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Arne SimonDepartment of Pediatric Hematology and Oncology, University Medical Center of Saarland, Homburg/Saar, Germany.ORCID https://orcid.org/0000-0001-9558-3330
Christian Dohna-SchwakeDepartment of Pediatrics I, Neonatology, Pediatric Intensive Care, Pediatric Infectiology, Pediatric Neurology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
Ines MackDepartment of Paediatric Infectious Diseases and Vaccinology, University Children's Hospital Basel (UKBB) and University of Basel, Basel, Switzerland.ORCID https://orcid.org/0000-0002-6648-7996
Nicole BodmerDepartment of Oncology, University Children's Hospital Zurich, Zurich, Switzerland.
Tim NiehuesCentre for Child and Adolescent Health, Helios Klinikum Krefeld, Germany.
Alexander ClaviezDepartment of Pediatrics, University Hospital Magdeburg, Magdeburg, Germany.ORCID https://orcid.org/0000-0001-7064-8556
Alfred LänglerDepartment of Paediatrics and Adolescent Medicine, Community Hospital Herdecke, Herdecke, Germany.ORCID https://orcid.org/0000-0002-1443-8236
Alfred LeipoldChildren's Hospital Karlsruhe, Karlsruhe, Germany.
Aram ProkopCampus University Medical School Hamburg (MSH), Helios Clinic Schwerin, Schwerin, Germany.
Bastian BrummelDepartment of Pediatric Oncology and Hematology, Klinikum Dortmund, Dortmund, Germany.
Beate WinklerDepartment of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Bernd GruhnDepartment of Pediatrics, Jena University Hospital, Jena, Germany.ORCID https://orcid.org/0000-0003-1862-0075
Carl Friedrich ClassenSection of Pediatric Oncology and Palliative Medicine, Klinik für Kinder- und Jugendmedizin, Universitätsmedizin Rostock, Rostock, Germany.
Carsten FriedrichDepartment of Pediatrics and Pediatric Hematology/Oncology, University Children's Hospital, Carl von Ossietzky Universität Oldenburg, Klinikum Oldenburg AöR, Oldenburg, Germany.
Christa KoenigPediatric Hematology/Oncology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Christian FlothoDivision of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany.
Fiona PoyerDepartment of Pediatric Hematology and Oncology, St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria.ORCID https://orcid.org/0000-0002-3393-9706
Freimut SchillingPediatric Oncology-Hematology, Children's Hospital of Central Switzerland, Lucerne, Switzerland.
Gabriele CalaminusDepartment of Pediatric Hematology and Oncology, University Hospital Bonn, Bonn, Germany.
Geeke SiebenPediatric Oncology and Hematology, University Medical Center Mannheim, Mannheim, Germany.
Georg C SchwabeChildren's Hospital, Medical University Lausitz-Carl Thiem, Cottbus, Germany.ORCID https://orcid.org/0000-0003-4299-3410
Harald ReinhardDepartment of Pediatrics, Asklepios Children's Hospital, Sankt Augustin, Germany.
Heiko-Manuel TeltschikDepartment of Hematology and Oncology, Children's Hospital Stuttgart-Olgahospital, Stuttgart, Germany.
Heinz HengartnerPediatric Hospital of Eastern Switzerland St Gallen, St Gallen, Switzerland.
Jana StursbergDepartment of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm, Germany.
Jeanette GreinerPediatric Oncology-Hematology, Children's Hopital, Cantonal Hospital Aarau, Aarau, Switzerland.
Johann GreilDepartment of Pediatric Hematology, Oncology and Immunology, University Hospital Heidelberg, Heidelberg, Germany.ORCID https://orcid.org/0000-0003-1821-1183
Jörg LeyhDepartment of Pediatric Hematology and Oncology, Klinik Hallerwiese-Cnopfsche Kinderklinik, Nürnberg, Germany.
Jörn-Sven KühlDepartment of Pediatric Oncology, Hematology and Hemostaseology, University of Leipzig, Leipzig, Germany.
Karoline EhlertDepartment of Pediatric Hematology and Oncology, University Medicine Greifswald, Greifswald, Germany.
Konrad BochennekDepartment of Pediatrics, Division of Hematology, Oncology and Hemostaseology, Goethe University Frankfurt, Frankfurt/Main, Germany, Frankfurt am Main, Germany.
Marius RohdePediatric Hematology and Oncology, University Hospital Giessen, Giessen, Germany.ORCID https://orcid.org/0000-0002-1487-525X
Martin DemmertClinic for Pediatric and Adolescent Medicine, University Hospital Schleswig-Holstein, Lübeck, Germany.ORCID https://orcid.org/0000-0001-7552-3736
Martina StiefelDepartment of Pediatrics, Martin-Luther-University Halle-Wittenberg, Halle, Germany.ORCID https://orcid.org/0009-0002-3277-7212
Matthias EyrichDepartment of Pediatric Haematology, Oncology and Stem Cell Transplantation, University Medical Center, University Children's Hospital, University of Würzburg, Würzburg, Germany.
Meinolf SiepermannClinic for Children and Youth Medicine, Department for Pediatric Hematology/Oncology, Children's Hospital Amsterdamer Straße, Cologne, Germany.
Michael FrühwaldSwabian Children's Cancer Center, Pediatrics and Adolescent Medicine, University Medical Center Augsburg, Augsburg, Germany.ORCID https://orcid.org/0000-0002-8237-1854
Michaela DöringDepartment of Paediatric Haematology/Oncology, Children's University Hospital, Tübingen, Germany.ORCID https://orcid.org/0000-0002-8134-7350
Michaela NathrathDepartment of Pediatrics and Children's Cancer Research Center, School of Medicine, Technical University of Munich, Munich, Germany.ORCID https://orcid.org/0000-0002-1584-1115
Milen MinkovDivision of Pediatric Oncology, Department of Pediatrics and Adolescent Medicine, Johannes Kepler University, Linz, Austria.ORCID https://orcid.org/0000-0001-6471-8423
Monika StreiterClinic for Pediatrics and Adolescent Medicine, Hematology/Oncology, Klinikum am Gesundbrunnen Heilbronn, Heilbronn, Germany.
Neil JonesDepartment of Pediatrics and Adolescent Medicine University Clinics, Salzburg, Austria.
Nora Naumann-BartschDepartment for Pediatrics and Adolescent Medicine, University Hospital Erlangen, Erlangen, Germany.ORCID https://orcid.org/0000-0001-5606-9822
Norbert JorchUniversity Children's Hospital, Evangelisches Klinikum Bethel, Bielefeld, Germany.
Olaf BeckDepartment of Pediatric Hematology/Oncology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.ORCID https://orcid.org/0000-0002-7448-6029
Rita BeierDepartment of Pediatric Hematology and Oncology, Hannover Medical School, Hannover, Germany.
Roman CrazzolaraDepartment of Pediatrics, Medical University of Innsbruck, Innsbruck, Austria.ORCID https://orcid.org/0000-0003-4336-6275
Silke KietzDepartment of Pediatric Hematology, Oncology and Stem Cell Transplantation, University of Regensburg, Regensburg, Germany.
Simon ViethDepartment of Pediatrics, University Hospital Schleswig-Holstein, Kiel, Germany.
Stefan FröhlingPediatric Oncology Center, Bremen-Mitte, Professor Hess Children's Hospital, Bremen, Germany.
Stephan LobitzPediatric Hematology & Oncology, Gemeinschaftsklinikum Mittelrhein, Koblenz, Germany.ORCID https://orcid.org/0000-0001-5398-0610
Sujal GhoshDepartment of Pediatric Oncology, Hematology and Clinical Immunology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany.ORCID https://orcid.org/0000-0001-5647-4262
Tanja C ValléeDr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany.ORCID https://orcid.org/0009-0003-0171-1146
Thilo MüllerDepartment of Pediatric Oncology and Hematology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Thomas WieselChildren's Hospital, Vestische Youth Hospital, University of Witten/Herdecke, Datteln, Germany.
Tobias DäbritzDepartment of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Udo KontnyDivision of Pediatric Hematology, Oncology and Stem Cell Transplantation, University Hospital Aachen, Aachen, Germany.
Uwe ThielClinic for Pediatrics and Adolescent Medicine, Hematology/Oncology, Klinikum am Gesundbrunnen Heilbronn, Heilbronn, Germany.ORCID https://orcid.org/0000-0002-3574-7337
Volker StrengerDepartment of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.ORCID https://orcid.org/0000-0002-6947-5894
Wolfgang R EberlDepartment of Hematology and Oncology, Center for Child and Adolescent Medicine, Städtisches Klinikum Braunschweig gGmbH, Braunschweig, Germany.
Oliver A CornelyInstitute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.ORCID https://orcid.org/0000-0001-9599-3137
Andreas H GrollInfectious Disease Research Program, Center for Bone Marrow Transplantation and Dept. of Pediatric Hematology/Oncology, University Children's Hospital Münster, Münster, Germany.ORCID https://orcid.org/0000-0003-1188-393X
Thomas LehrnbecherDepartment of Pediatrics, Division of Hematology, Oncology and Hemostaseology, Goethe University Frankfurt, Frankfurt/Main, Germany, Frankfurt am Main, Germany.ORCID https://orcid.org/0000-0002-6022-3439

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInvasive 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.

methodsA 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.

resultsSixty-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.

conclusionsThe 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.

Indexed as

Cancer Care FacilitiesInvasive Fungal InfectionsNeoplasmsAntifungal AgentsAustriaChildGermanyHumansIncidenceSurveys and QuestionnairesSwitzerlandAntifungal Agentsantifungal stewardshipaspergillosiscancercandidaemiachildrendiagnosismanagementmycosesprophylaxistreatment

Identifiers

PMID40515497
PMCPMC12166348

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.