Key issues for the immunocompromised host in 2013 will be discussed:

1. Invasive fungal infections (IFI) how to prevent, diagnose early and treat optimally
2. A personalized approach to defining risk for infection
3. The emergence of multi-resistant organisms (MRO) and antimicrobial stewardship

(IFI) remain a leading infectious cause of mortality in patients with haematological malignancies. Risk groups for fungal infection are expanding with the introduction of new therapies. Traditional approaches to reducing the incidence and mortality of these infections such as antifungal prophylaxis and empiric antifungal therapy (EAFT) have had limited success in reducing mortality. Recently non-culture biomarker tests for surveillance and directing early treatment of fungal infection have been evaluated. However, local epidemiology and prevalence of fungal infection, impact of construction and building works, and the availability of diagnostic testing need to be considered in a decision as to whether prophylaxis, screening or a diagnostic driven approach is justified. Bacterial infections are the most frequent infections seen in the immunocompromised and infections caused by MROs in this population are an emerging threat, requiring good infection control practices and antibiotic oversight.
Personalised approaches to quantifying risk for infection are evolving including genetic testing, immunological profiling and evaluation of the microbiome.