The current state of laboratory mycology in Asia/Pacific: A survey from the European Confederation of Medical Mycology (ECMM) and International Society for Human and Animal Mycology (ISHAM)

Introduction: Invasive fungal infections (IFIs) in Asia/Pacific are a particular threat to patients with malig-nancies, uncontrolled diabetes mellitus or undiagnosed/untreated human immunodeficiency virus infec-tion 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, serol-ogy, 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 ques-tionnaire. 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 manage-ment 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.(c) 2023 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license ( http://creativecommons.org/licenses/by/4.0/ )

Automated summary

Invasive fungal infections pose a significant threat to patients in Asia/Pacific with malignancies, uncontrolled diabetes mellitus, undiagnosed/untreated HIV/AIDS. Adequate access to diagnostic tools and antifungals is essential for IFI management and patient survival.