Infectious complications are still a major cause of morbidity and mortality in children receiving therapy for cancer or undergoing hematopoietic stem cell transplantation. Current supportive care strategies consider numerous factors for defining the risk for an infection, but these risk-prediction models need to be refined to ultimately personalize anti-infective measures for an individual patient. It has been recognized that the performance of diagnostic tools including serum markers and imaging may differ between children and adults, and future studies have to assess in the pediatric population the combination of specific diagnostic tools in order to improve the early and reliable diagnosis of an infection. There is an ongoing debate on systemic anti-bacterial and antifungal prophylaxis, as these strategies have to weigh individual benefits of reducing infectious complications against the risk of increasing resistance rates in patients and within institutions. Although there was considerable progress in supportive anti-infective care strategies in children and adolescents over the last 2 decades, which resulted in the development of pediatric specific clinical practice guidelines, major effort is needed to close the open research gaps.

中文翻译：

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免疫受损宿主管理的最新进展和未来方向。

感染性并发症仍然是接受癌症治疗或进行造血干细胞移植的儿童发病和死亡的主要原因。当前的支持性护理策略考虑了许多因素来定义感染的风险，但是需要完善这些风险预测模型，以最终针对个别患者个性化抗感染措施。已经认识到，儿童和成人之间包括血清标志物和影像学在内的诊断工具的性能可能有所不同，未来的研究必须评估儿科人群中特定诊断工具的组合，以改善感染的早期和可靠诊断。 。关于全身性抗菌和抗真菌药物的预防正在进行中，因为这些策略必须权衡降低感染并发症的个人益处与增加患者和机构内耐药率的风险。尽管在过去的20年中，儿童和青少年在支持性抗感染护理策略方面取得了长足的进步，这导致了儿科特定临床实践指南的制定，但仍需要付出巨大的努力来弥合开放的研究空白。