A bone marrow transplant recipient may be at increased risk for nosocomial pneumonia at various phases of care. Control of risk factors can reduce the incidence of these infections.
Patient selection: bone marrow transplant
Common fungal pathogens are Aspergillus and Candida species, but many genera of fungi may be involved. Some fungal pathogens may be resistant to commonly used antifungal agents.
Risk factors for nosocomial fungal pneumonia:
(1) hospital renovation
(2) graft-vs-host disease with prolonged immunosuppression
(3) failure to use isolation room with air filtration when indicated
(4) defect in air handling system for isolation room
(5) leaving isolation room for a procedure without adequate precautions
(6) history of fungal infection
(7) failure to use antifungal prophylaxis
(8) other nosocomial infection
(9) therapy with methotrexate or corticosteroids
(10) natural disaster with disruption of utilities
(11) prolonged neutropenia
