Multicentric Study on the Clinical Mycology Capacity and Access to Antifungal Treatment in Portugal
The success of the clinical management of invasive fungal diseases (IFD) is highly dependent on suitable tools for timely and accurate diagnosis for effective treatment. An in-depth analysis of the ability of European institutions to promptly and accurately diagnose IFD was previously conducted to i...
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Veröffentlicht in: | Mycopathologia (1975) 2024-02, Vol.189 (1), p.15-15, Article 15 |
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description | The success of the clinical management of invasive fungal diseases (IFD) is highly dependent on suitable tools for timely and accurate diagnosis for effective treatment. An in-depth analysis of the ability of European institutions to promptly and accurately diagnose IFD was previously conducted to identify limitations and aspects to improve. Here, we evaluated and discussed the specific case of Portugal, for which, to our knowledge, there are no reports describing the national mycological diagnostic capacity and access to antifungal treatment. Data from 16 Portuguese medical institutions were collected via an online electronic case report form covering different parameters, including institution profile, self-perceived IFD incidence, target patients, diagnostic methods and reagents, and available antifungals. The majority of participating institutions (69%) reported a low-very low incidence of IFD, with
Candida
spp. indicated as the most relevant fungal pathogen, followed by
Aspergillus
spp. and
Cryptococcus
spp. All institutions had access to culture and microscopy, whereas 94 and 88% were able to run antigen-detection assays and molecular tests, respectively. All of the institutions capable of providing antifungal therapy declared to have access to at least one antifungal. However, echinocandins were only available at 85% of the sites. Therapeutic drug monitoring (TDM) was reported to remain a very restricted practice in Portugal, being available in 19% of the institutions, with the TDM of itraconazole and posaconazole performed in only 6% of them. Importantly, several of these resources are outsourced to external entities. Except for TDM, Portugal appears to be well-prepared concerning the overall capacity to diagnose and treat IFD. Future efforts should focus on promoting the widespread availability of TDM and improved access to multiple classes of antifungals, to further improve patient outcomes. |
doi_str_mv | 10.1007/s11046-024-00830-9 |
format | Article |
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Candida
spp. indicated as the most relevant fungal pathogen, followed by
Aspergillus
spp. and
Cryptococcus
spp. All institutions had access to culture and microscopy, whereas 94 and 88% were able to run antigen-detection assays and molecular tests, respectively. All of the institutions capable of providing antifungal therapy declared to have access to at least one antifungal. However, echinocandins were only available at 85% of the sites. Therapeutic drug monitoring (TDM) was reported to remain a very restricted practice in Portugal, being available in 19% of the institutions, with the TDM of itraconazole and posaconazole performed in only 6% of them. Importantly, several of these resources are outsourced to external entities. Except for TDM, Portugal appears to be well-prepared concerning the overall capacity to diagnose and treat IFD. Future efforts should focus on promoting the widespread availability of TDM and improved access to multiple classes of antifungals, to further improve patient outcomes.</description><identifier>ISSN: 0301-486X</identifier><identifier>EISSN: 1573-0832</identifier><identifier>DOI: 10.1007/s11046-024-00830-9</identifier><identifier>PMID: 38265528</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject>Antifungal Agents ; Antigens ; Biomedical and Life Sciences ; Case reports ; Chronic obstructive pulmonary disease ; COVID-19 ; Echinocandins ; Eukaryotic Microbiology ; Fungal infections ; Health care ; Hospitals ; Humans ; Influenza ; Invasive Fungal Infections ; Itraconazole ; Laboratories ; Life Sciences ; Medical Microbiology ; Medicine ; Microbial Ecology ; Microbiology ; Mycology ; Original ; Original Article ; Patients ; Plant Sciences ; Portugal ; Posaconazole ; Socioeconomic factors ; Therapeutic drug monitoring ; Viral infections</subject><ispartof>Mycopathologia (1975), 2024-02, Vol.189 (1), p.15-15, Article 15</ispartof><rights>The Author(s) 2024</rights><rights>2024. The Author(s).</rights><rights>The Author(s) 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c475t-cc2575ba7f9ca19892d2ca1acdf0646372fb975b0f3eb65e46489b6e93c179293</citedby><cites>FETCH-LOGICAL-c475t-cc2575ba7f9ca19892d2ca1acdf0646372fb975b0f3eb65e46489b6e93c179293</cites><orcidid>0000-0001-8935-8030</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11046-024-00830-9$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11046-024-00830-9$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38265528$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fernandes, Raquel</creatorcontrib><creatorcontrib>Sabino, Raquel</creatorcontrib><creatorcontrib>Cunha, Cristina</creatorcontrib><creatorcontrib>Cornely, Oliver A.</creatorcontrib><creatorcontrib>Carvalho, Agostinho</creatorcontrib><creatorcontrib>Salmanton-García, Jon</creatorcontrib><creatorcontrib>PT Group for IFI Management Capacity</creatorcontrib><creatorcontrib>PT Group for IFI Management Capacity</creatorcontrib><title>Multicentric Study on the Clinical Mycology Capacity and Access to Antifungal Treatment in Portugal</title><title>Mycopathologia (1975)</title><addtitle>Mycopathologia</addtitle><addtitle>Mycopathologia</addtitle><description>The success of the clinical management of invasive fungal diseases (IFD) is highly dependent on suitable tools for timely and accurate diagnosis for effective treatment. An in-depth analysis of the ability of European institutions to promptly and accurately diagnose IFD was previously conducted to identify limitations and aspects to improve. Here, we evaluated and discussed the specific case of Portugal, for which, to our knowledge, there are no reports describing the national mycological diagnostic capacity and access to antifungal treatment. Data from 16 Portuguese medical institutions were collected via an online electronic case report form covering different parameters, including institution profile, self-perceived IFD incidence, target patients, diagnostic methods and reagents, and available antifungals. The majority of participating institutions (69%) reported a low-very low incidence of IFD, with
Candida
spp. indicated as the most relevant fungal pathogen, followed by
Aspergillus
spp. and
Cryptococcus
spp. All institutions had access to culture and microscopy, whereas 94 and 88% were able to run antigen-detection assays and molecular tests, respectively. All of the institutions capable of providing antifungal therapy declared to have access to at least one antifungal. However, echinocandins were only available at 85% of the sites. Therapeutic drug monitoring (TDM) was reported to remain a very restricted practice in Portugal, being available in 19% of the institutions, with the TDM of itraconazole and posaconazole performed in only 6% of them. Importantly, several of these resources are outsourced to external entities. Except for TDM, Portugal appears to be well-prepared concerning the overall capacity to diagnose and treat IFD. Future efforts should focus on promoting the widespread availability of TDM and improved access to multiple classes of antifungals, to further improve patient outcomes.</description><subject>Antifungal Agents</subject><subject>Antigens</subject><subject>Biomedical and Life Sciences</subject><subject>Case reports</subject><subject>Chronic obstructive pulmonary disease</subject><subject>COVID-19</subject><subject>Echinocandins</subject><subject>Eukaryotic Microbiology</subject><subject>Fungal infections</subject><subject>Health care</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Influenza</subject><subject>Invasive Fungal Infections</subject><subject>Itraconazole</subject><subject>Laboratories</subject><subject>Life Sciences</subject><subject>Medical Microbiology</subject><subject>Medicine</subject><subject>Microbial Ecology</subject><subject>Microbiology</subject><subject>Mycology</subject><subject>Original</subject><subject>Original Article</subject><subject>Patients</subject><subject>Plant Sciences</subject><subject>Portugal</subject><subject>Posaconazole</subject><subject>Socioeconomic factors</subject><subject>Therapeutic drug monitoring</subject><subject>Viral infections</subject><issn>0301-486X</issn><issn>1573-0832</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9kUtv1DAUhS1ERacDf4AFssSGTei1ncT2Co1GtCC1AokisbMcx5m6ytiD7VTKv6_blPJYsPLjfvdcHx-EXhN4TwD4aSIE6rYCWlcAgkEln6EVaTiryok-RytgQKpatD-O0UlKNwCljfAX6JgJ2jYNFStkLqcxO2N9js7gb3nqZxw8ztcWb0fnndEjvpxNGMNuxlt90MblGWvf440xNiWcA9747IbJ7wp6Fa3O-6KGncdfQ8xTuX2JjgY9JvvqcV2j72cfr7afqosv55-3m4vK1LzJlTG04U2n-SCNJlJI2tOy0aYfoK1bxunQyQLAwGzXNrZuayG71kpmCJdUsjX6sOgepm5v-wdTelSH6PY6zipop_6ueHetduFWERAg6jJijd49KsTwc7Ipq71Lxo6j9jZMSVFJBJGcNqKgb_9Bb8IUffG3UEyUPy4UXSgTQ0rRDk-vIaDuQ1RLiKqEqB5CVPc-3vzp46nlV2oFYAuQSsnvbPw9-z-ydxTRqKs</recordid><startdate>20240201</startdate><enddate>20240201</enddate><creator>Fernandes, Raquel</creator><creator>Sabino, Raquel</creator><creator>Cunha, Cristina</creator><creator>Cornely, Oliver A.</creator><creator>Carvalho, Agostinho</creator><creator>Salmanton-García, Jon</creator><general>Springer Netherlands</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>M7N</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-8935-8030</orcidid></search><sort><creationdate>20240201</creationdate><title>Multicentric Study on the Clinical Mycology Capacity and Access to Antifungal Treatment in Portugal</title><author>Fernandes, Raquel ; Sabino, Raquel ; Cunha, Cristina ; Cornely, Oliver A. ; Carvalho, Agostinho ; Salmanton-García, Jon</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c475t-cc2575ba7f9ca19892d2ca1acdf0646372fb975b0f3eb65e46489b6e93c179293</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Antifungal Agents</topic><topic>Antigens</topic><topic>Biomedical and Life Sciences</topic><topic>Case reports</topic><topic>Chronic obstructive pulmonary disease</topic><topic>COVID-19</topic><topic>Echinocandins</topic><topic>Eukaryotic Microbiology</topic><topic>Fungal infections</topic><topic>Health care</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Influenza</topic><topic>Invasive Fungal Infections</topic><topic>Itraconazole</topic><topic>Laboratories</topic><topic>Life Sciences</topic><topic>Medical Microbiology</topic><topic>Medicine</topic><topic>Microbial Ecology</topic><topic>Microbiology</topic><topic>Mycology</topic><topic>Original</topic><topic>Original Article</topic><topic>Patients</topic><topic>Plant Sciences</topic><topic>Portugal</topic><topic>Posaconazole</topic><topic>Socioeconomic factors</topic><topic>Therapeutic drug monitoring</topic><topic>Viral infections</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fernandes, Raquel</creatorcontrib><creatorcontrib>Sabino, Raquel</creatorcontrib><creatorcontrib>Cunha, Cristina</creatorcontrib><creatorcontrib>Cornely, Oliver A.</creatorcontrib><creatorcontrib>Carvalho, Agostinho</creatorcontrib><creatorcontrib>Salmanton-García, Jon</creatorcontrib><creatorcontrib>PT Group for IFI Management Capacity</creatorcontrib><creatorcontrib>PT Group for IFI Management Capacity</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Mycopathologia (1975)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fernandes, Raquel</au><au>Sabino, Raquel</au><au>Cunha, Cristina</au><au>Cornely, Oliver A.</au><au>Carvalho, Agostinho</au><au>Salmanton-García, Jon</au><aucorp>PT Group for IFI Management Capacity</aucorp><aucorp>PT Group for IFI Management Capacity</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Multicentric Study on the Clinical Mycology Capacity and Access to Antifungal Treatment in Portugal</atitle><jtitle>Mycopathologia (1975)</jtitle><stitle>Mycopathologia</stitle><addtitle>Mycopathologia</addtitle><date>2024-02-01</date><risdate>2024</risdate><volume>189</volume><issue>1</issue><spage>15</spage><epage>15</epage><pages>15-15</pages><artnum>15</artnum><issn>0301-486X</issn><eissn>1573-0832</eissn><abstract>The success of the clinical management of invasive fungal diseases (IFD) is highly dependent on suitable tools for timely and accurate diagnosis for effective treatment. An in-depth analysis of the ability of European institutions to promptly and accurately diagnose IFD was previously conducted to identify limitations and aspects to improve. Here, we evaluated and discussed the specific case of Portugal, for which, to our knowledge, there are no reports describing the national mycological diagnostic capacity and access to antifungal treatment. Data from 16 Portuguese medical institutions were collected via an online electronic case report form covering different parameters, including institution profile, self-perceived IFD incidence, target patients, diagnostic methods and reagents, and available antifungals. The majority of participating institutions (69%) reported a low-very low incidence of IFD, with
Candida
spp. indicated as the most relevant fungal pathogen, followed by
Aspergillus
spp. and
Cryptococcus
spp. All institutions had access to culture and microscopy, whereas 94 and 88% were able to run antigen-detection assays and molecular tests, respectively. All of the institutions capable of providing antifungal therapy declared to have access to at least one antifungal. However, echinocandins were only available at 85% of the sites. Therapeutic drug monitoring (TDM) was reported to remain a very restricted practice in Portugal, being available in 19% of the institutions, with the TDM of itraconazole and posaconazole performed in only 6% of them. Importantly, several of these resources are outsourced to external entities. Except for TDM, Portugal appears to be well-prepared concerning the overall capacity to diagnose and treat IFD. Future efforts should focus on promoting the widespread availability of TDM and improved access to multiple classes of antifungals, to further improve patient outcomes.</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><pmid>38265528</pmid><doi>10.1007/s11046-024-00830-9</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0001-8935-8030</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Antifungal Agents Antigens Biomedical and Life Sciences Case reports Chronic obstructive pulmonary disease COVID-19 Echinocandins Eukaryotic Microbiology Fungal infections Health care Hospitals Humans Influenza Invasive Fungal Infections Itraconazole Laboratories Life Sciences Medical Microbiology Medicine Microbial Ecology Microbiology Mycology Original Original Article Patients Plant Sciences Portugal Posaconazole Socioeconomic factors Therapeutic drug monitoring Viral infections |
title | Multicentric Study on the Clinical Mycology Capacity and Access to Antifungal Treatment in Portugal |
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