Infektionsmanagement bei Immunsupprimierten

Eine Hauptursache von Hospitalisierung und Letalität Immunsupprimierter sind Infektionen. Deren Management, Prävention und Therapie spielen eine entscheidende Rolle für Überleben und Lebensqualität. Es existieren zahlreiche Leitlinien und Empfehlungen für das Management von Infektionen bei Immunsupprimierten. Überschneidungen von Infektiologie, Hygiene, Hämatologie und Onkologie führen zu teils voneinander abweichenden Empfehlungen. Dieser Artikel gibt einen Überblick über die aktuell bestehende Evidenz und die Leitlinien zum Infektionsmanagement bei Immunsupprimierten.

Abstract

The number of immunosuppressed patients continues to increase worldwide. The main reasons are the demographic development and improved long-term survival, also for patients under immunosuppression. A major cause of hospitalization and mortality among these patients are infections. Their management, including prevention and adequate treatment, plays a crucial role in survival and quality of life, but also with regard to economic factors.

Infection management in immunocompromised patients faces new challenges today. Not only the increasing number, but also new groups of patients at risk and an increasingly aging and comorbid population pose problems for the treating physicians. While cancer medicine is no longer determined solely by radiotherapy and chemotherapy, new targeted substances are playing an increasingly important role. In addition, new targeted substances complicate adequate infection prophylaxis due to potential interactions. The worldwide increase in antibiotic-resistant pathogens complicates treatment of bacterial infections, which is associated with increased mortality, especially in the immunocompromised patient population. Further, the disruption of the microbiome shows negative antibiotic-associated effects. Hence the reasonable use of anti-infectives in prophylaxis and therapy is of great importance.

There are many recommendations and guidelines for clinicians regarding the management of infections in immunocompromised patients. Overlaps of infectiology, hygiene as well as hematology and oncology sometimes lead to different recommendations. This article provides an overview of the currently existing evidence and guidelines for infection management in immunosuppressed patients.

Schlüsselwörter

Immunsuppression - virale Infektionen - bakterielle Infektionen - Pilzinfektionen - Management

Key words

Immunosuppression - viral infections - bacterial infections - fungal infections - management

Publication History

Article published online:
04 July 2022

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