{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T16:36:01Z","timestamp":1785429361422,"version":"3.56.0"},"reference-count":152,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Funda\u00e7\u00e3o de Amparo a Pesquisa do Estado de S\u00e3o Paulo\u2014FAPESP","award":["2021\/10599-3"],"award-info":[{"award-number":["2021\/10599-3"]}]},{"award":["2021\/10599-3"],"award-info":[{"award-number":["2021\/10599-3"]}],"id":[{"id":"https:\/\/ror.org\/02ddkpn78","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Breakthrough invasive fungal infections (bIFIs) are a challenging serious complication in high-risk hematologic patients and allogeneic hematopoietic stem cell transplantation recipients that may negatively impact their outcome. Despite advances in antifungal prophylaxis, diagnostics, and supportive care, bIFI occurrence reflects a complex interaction between host immunosuppression, emergence of resistant pathogens and pharmacological variables, including subtherapeutic drug exposure. Candida spp. have shifted towards non-albicans yeasts, whereas breakthrough mold infections more frequently involve non-fumigatus Aspergillus, Mucorales, Fusarium spp., and Scedosporium\/Lomentospora spp. Early clinical recognition, rapid therapy escalation, aggressive diagnostic investigation, a switch to liposomal amphotericin B-based regimens in patients on azole prophylaxis, and therapeutic drug monitoring are essential to improve outcomes. Reducing the growing global burden of bIFIs will also require improved access to high-quality diagnostics and strengthened educational and stewardship efforts that prioritize antifungal resistance as an urgent health concern.<\/jats:p>","DOI":"10.3390\/microorganisms14040904","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T15:14:12Z","timestamp":1776352452000},"page":"904","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Managing Breakthrough Fungal Infections in Hematologic Patients: Determinants and Practical Management from a Latin American Perspective on Behalf of INFOCUS LATAM\u2013ISHAM Working Group"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-0959-8180","authenticated-orcid":false,"given":"Larissa Sim\u00e3o","family":"Gandolpho","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Escola Paulista de Medicina da Universidade Federal de S\u00e3o Paulo, S\u00e3o Paulo 04023-062, Brazil"},{"name":"Hospital Nove de Julho, S\u00e3o Paulo 04023-062, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7482-1301","authenticated-orcid":false,"given":"Daniel","family":"Aguilar-Zapata","sequence":"additional","affiliation":[{"name":"Infectious Diseases and Hospital Epidemiology, Mexico City 14080, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9170-3016","authenticated-orcid":false,"given":"Pablo Andr\u00e9s","family":"Moncada-Vallejo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Fundacion Valle del Lili, Cali 760032, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Riera","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Sanatorio Allende, C\u00f3rdoba X5000, Argentina"},{"name":"Research Group of Immunology and Mycology, C\u00f3rdoba X5000, Argentina"},{"name":"Facultad de Ciencias M\u00e9dicas, Universidad Nacional de C\u00f3rdoba, I Catedra de Infectolog\u00eda, C\u00f3rdoba X5000, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0077-4121","authenticated-orcid":false,"given":"Mariana","family":"Guaran\u00e1","sequence":"additional","affiliation":[{"name":"Hospital Universit\u00e1rio Gaffr\u00e9e e Guinle, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro 20270-001, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni Luis","family":"Breda","sequence":"additional","affiliation":[{"name":"Hospital de Cl\u00ednicas, Universidade Federal do Paran\u00e1, Curitiba 80060-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0574-8312","authenticated-orcid":false,"given":"Ricardo","family":"Rabagliati","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Faculty of Medicine, Pontificia Universidad Cat\u00f3lica de Chile, Santiago 8331150, Chile"},{"name":"Red de Salud UC CHRISTUS, Santiago 8320000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4867-0014","authenticated-orcid":false,"given":"Marcio","family":"Nucci","sequence":"additional","affiliation":[{"name":"Division of Hematology, Internal Medicine Department, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-913, Brazil"},{"name":"Grupo Oncocl\u00ednicas, Rio de Janeiro 22250-905, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0793-8491","authenticated-orcid":false,"given":"Arnaldo Lopes","family":"Colombo","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Escola Paulista de Medicina da Universidade Federal de S\u00e3o Paulo, S\u00e3o Paulo 04023-062, Brazil"},{"name":"Antimicrobial Resistance Institute of S\u00e3o Paulo (ARIES), S\u00e3o Paulo 04023-062, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"ofab596","DOI":"10.1093\/ofid\/ofab596","article-title":"Invasive Mold Infections in Allogeneic Hematopoietic Cell Transplant Recipients in 2020: Have We Made Enough Progress?","volume":"9","author":"Roth","year":"2022","journal-title":"Open Forum Infect. 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