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Salmanton-García, Jon; Au, Wing-Yan; Hoenigl, Martin; Chai, Louis Yi Ann; Badali, Hamid; Basher, Ariful; Brockhoff, Ronja A.; Chen, Sharon C.-A.; Chindamporn, Ariya; Chowdhary, Anuradha; Heath, Christopher H.; Jabeen, Kausar; Lee, Jaehyeon; Matar, Madonna; Taj-Aldeen, Saad Jaber; Tan, Ban Hock; Uno, Kenji; Wahyuningsih, Retno; Zhu, Liping; Chakrabarti, Arunaloke; Cornely, Oliver A.
International journal of antimicrobial agents, March 2023, 2023-Mar, 2023-03-00, 20230301, Volume: 61, Issue: 3Journal Article
•Diagnostic tools in laboratory mycology are in continuous development worldwide, including validation of new techniques.•Economical or geographical factors may play a key role in the incidence and clinical handling of invasive fungal infections (IFIs).•Efforts to depict the status of the diagnostic capacity for IFIs have been made at a pan-Asia/Pacific level.•IFI diagnostic status and therapeutic capabilities in Asia/Pacific are heterogeneous because of IFI endemicity and burden and economic resources.•Partnerships are required to advance understanding, diagnostics and management of IFI, and to augment fungal surveillance data. Introduction: Invasive fungal infections (IFIs) in Asia/Pacific are a particular threat to patients with malignancies, uncontrolled diabetes mellitus or undiagnosed/untreated human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS). Adequate and early access to diagnostic tools and antifungals is essential for IFI clinical management and patient survival. Methods: Details on institution profile, self-perception on IFI, and access to microscopy, culture, serology, antigen detection, molecular testing, and therapeutic drug monitoring for IFI were collected in a survey. Results: As of June 2022, 235 centres from 40 countries/territories in Asia/Pacific answered the questionnaire. More than half the centres were from six countries: India (25%), China (17%), Thailand (5%), Indonesia, Iran, and Japan (4% each). Candida spp. (93%) and Aspergillus spp. (75%) were considered the most relevant pathogens. Most institutions had access to microscopy (98%) or culture-based approaches (97%). Furthermore, 79% of centres had access to antigen detection, 66% to molecular assays, and 63% to antibody tests. Access to antifungals varied between countries/territories. At least one triazole was available in 93% of the reporting sites (voriconazole 89% was the most common mould-active azole), whereas 80% had at least one amphotericin B formulation, and 72% had at least one echinocandin. Conclusion: According to the replies provided, the resources available for IFI diagnosis and management vary among Asia/Pacific countries/territories. Economical or geographical factors may play a key role in the incidence and clinical handling of this disease burden. Regional cooperation may be a good strategy to overcome shortcomings.
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