Oncology Nurses Concerned About Invasive Fungal Infections, Survey Shows

August 3, 2010

ONSEdge, a healthcare education company and the for-profit subsidiary of the Oncology Nursing Society, released the findings of a recent survey of oncology nurses that show they are increasingly concerned about invasive fungal infections (IFIs) in their patients. Oncology nurses clearly recognize the importance of IFIs to patients who undergo stem cell transplantation and/or high-dose chemotherapy.

-- Oncology nurses understand the risk of IFIs in certain oncology categories: Seventy percent of respondents indicated that patients with myelodysplastic syndromes (MDS) who were neutropenic were at high to very high risk for IFIs. Additionally, 79 percent indicated that patients with acute myelogenous leukemia who were neutropenic were at high to very high risk. Finally, 66 percent believed that patients who were stem cell transplant recipients and who developed graft-versus-host-disease (GVHD) were at high to very high risk.

-- Oncology nurses understand the importance of prophylaxis: Seventy-seven percent agreed with the statement, "I am convinced that antifungal prophylaxis is the best approach to managing the risk of developing invasive fungal infection."

-- Oncology nurses are increasingly concerned about IFIs: Sixty-eight percent agreed with the statement, "I am increasingly concerned about invasive fungal infections as a complication in my high-risk patients."

An ONSEdge white paper titled, "Knowledge Report: Invasive Fungal Infections," which reviews the survey findings and provides additional information, confirms that oncology nurses concerns about a rise of IFIs in patients with cancer are well founded. The report details the likely cause of the increase, patients who are at most risk, and what can be done to prevent IFIs.

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 transplant (HSCT). Because such patients are highly susceptible to bacterial and viral infections, oncology nurses are concerned about the significant number of opportunistic infections due to fungi, especially Aspergillus.

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

-- Individuals with profound, prolonged neutropenia (low white cell counts)

-- Individuals with acute leukemia, myelodysplastic syndromes

-- Allogeneic hematopoietic stem cell transplantation (HSCT) recipients

-- Individuals with graft-versus-host-disease (GVHD a frequent complication of HSCT)

-- Autologous HSCT recipients with mucositis

The white paper includes recommendations on how oncology nurses and other healthcare providers can play a major role in preventing and/or minimizing IFIs in their immunosuppressed patients. They must be prepared by:

-- Understanding how to identify high-risk patients

-- Recognizing the sources of IFIs and the vectors by which they are transmitted

-- Maintaining a high level of suspicion that any symptoms experienced by patients could be caused by IFIs

-- Knowing and applying the established clinical practice guidelines for prevention and treatment

The survey was funded by Merck & Co., Inc., Whitehouse Station, N.J.

For the full report, visit www.onsedge.com/pdf/IFIKnowledgeReport.pdf.