{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T11:00:10Z","timestamp":1785236410335,"version":"3.55.0"},"reference-count":40,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Immunocompromised children with hematologic malignancies or undergoing allogeneic haematopoietic stem cell transplantation (HSCT) are at high risk for invasive fungal diseases (IFDs). Reported incidence varies considerably due to heterogeneous diagnostic criteria, antifungal strategies and environmental conditions. Environmental preventive measures, although highly relevant, remain underrecognised determinants of IFD incidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective, single\u2010centre trial included paediatric cancer or transplant patients at high risk for IFD treated before (Cohort 1) and after (Cohort 2) relocation of a paediatric cancer centre from a 1990s building to a state\u2010of\u2010the\u2010art facility with improved environmental protection standards (observation periods: 56 and 12\u2009months, respectively). Antifungal prophylaxis continuously followed local standards. IFD was diagnosed according to 2019 EORTC\/MSGERC criteria. Primary endpoint was IFD incidence; secondary endpoints included prophylaxis use, IFD management and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      This study included 186 patients (Cohort 1:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009140; Cohort 2:\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200946). Baseline characteristics were comparable between both cohorts. Adherence to prophylaxis standards exceeded 98%, with liposomal amphotericin B being the most common agent. In Cohort 1, 25 possible, probable, or proven IFD occurred, mainly pulmonary aspergillosis, whereas no cases were observed following implementation of environmental measures in Cohort 2 (17.9% vs. 0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). Most IFD cases occurred in HSCT recipients. IFD was associated with increased mortality (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this contemporary paediatric cancer and transplant setting, environmental protective measures were associated with a marked reduction in IFD incidence, complementing consistent pharmacologic prophylaxis. These findings underscore environmental protection as essential for IFD prevention in high\u2010risk paediatric populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/myc.70204","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T09:42:12Z","timestamp":1782726132000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Underestimated Role of Environmental Factors in the Prevention of Invasive Fungal Disease: Experience From a European Childhood Cancer Centre"],"prefix":"10.1111","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1595-2365","authenticated-orcid":false,"given":"Stefano","family":"Malvestiti","sequence":"first","affiliation":[{"name":"Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, Children's Hospital Faculty of Medicine, Medical Center\u2014University of Freiburg  Freiburg 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Freiburg  Freiburg Germany"},{"name":"Center for Chronic Immunodeficiency (CCI), Institute for Immunodeficiency Medical Center\u2014University of Freiburg, Faculty of Medicine, Albert\u2010Ludwigs\u2010University of Freiburg  Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigitte","family":"Strahm","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, Children's Hospital Faculty of Medicine, Medical Center\u2014University of Freiburg  Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8517-9681","authenticated-orcid":false,"given":"Tobias","family":"Feuchtinger","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, Children's Hospital Faculty of Medicine, Medical Center\u2014University of Freiburg  Freiburg 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