State of Medical Mycology at German Academic Medical Centres: A Survey of the German-Speaking Mycological Society (DMYKG) and the Paul-Ehrlich-Society for Chemotherapy (PEG).
infections
mycoses
patient care
research
teaching
Journal
Mycoses
ISSN: 1439-0507
Titre abrégé: Mycoses
Pays: Germany
ID NLM: 8805008
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
revised:
21
06
2021
received:
26
04
2021
accepted:
22
06
2021
pubmed:
29
6
2021
medline:
7
1
2022
entrez:
28
6
2021
Statut:
ppublish
Résumé
Little is known about the infrastructure to translate advances in the management of patients at risk to develop invasive opportunistic fungal diseases. To assess the current state of Medical Mycology support in Germany, we conducted a survey among all 36 academic medical centres. The survey consisted of a 3-pages questionnaire sent out in the first half of 2019. Information included details of infrastructure, education and teaching; consultation services and interdisciplinary conferences; research activities and participation in network groups; radiology, microbiology and pharmacology support; publication activity; and European Confederation for Medical Mycology (ECMM) Excellence Center designation, if assigned. Information was returned from 24 centres (67%). Thirteen institutions (54%) reported an independent infectious disease, and two a separate Medical Mycology department (8%); a Medical Mycology working group was reported for nine institutions (38%). An infectious disease consultation service was existent in 16 institutions (67%) and a multidisciplinary conference in 13 (54%). Fifteen institutions reported a separate study office with activities in infectious disease studies (63%). Laboratory capability for fungal identification and susceptibility testing was confirmed by all 24 institutions; testing of galactomannan by 23 (96%), cryptococcal antigen by 21 (88%), ß-D-Glucan by 9 (38%), and panfungal and Pneumocystis PCR by 21 and 22 (88% and 92%), respectively. Therapeutic drug monitoring of voriconazole was reported to be available in 15 (63%) institutions with a turnaround of ≤24 h during weekdays in 10 (42%). Two of the 24 University hospitals (8%) reported ECMM Diamond Excellence Status. The results of this survey document the continuing need to improve the availability of specialised Medical Mycology support in German academic medical centres.
Sections du résumé
BACKGROUND
BACKGROUND
Little is known about the infrastructure to translate advances in the management of patients at risk to develop invasive opportunistic fungal diseases. To assess the current state of Medical Mycology support in Germany, we conducted a survey among all 36 academic medical centres.
METHODS
METHODS
The survey consisted of a 3-pages questionnaire sent out in the first half of 2019. Information included details of infrastructure, education and teaching; consultation services and interdisciplinary conferences; research activities and participation in network groups; radiology, microbiology and pharmacology support; publication activity; and European Confederation for Medical Mycology (ECMM) Excellence Center designation, if assigned.
RESULTS
RESULTS
Information was returned from 24 centres (67%). Thirteen institutions (54%) reported an independent infectious disease, and two a separate Medical Mycology department (8%); a Medical Mycology working group was reported for nine institutions (38%). An infectious disease consultation service was existent in 16 institutions (67%) and a multidisciplinary conference in 13 (54%). Fifteen institutions reported a separate study office with activities in infectious disease studies (63%). Laboratory capability for fungal identification and susceptibility testing was confirmed by all 24 institutions; testing of galactomannan by 23 (96%), cryptococcal antigen by 21 (88%), ß-D-Glucan by 9 (38%), and panfungal and Pneumocystis PCR by 21 and 22 (88% and 92%), respectively. Therapeutic drug monitoring of voriconazole was reported to be available in 15 (63%) institutions with a turnaround of ≤24 h during weekdays in 10 (42%). Two of the 24 University hospitals (8%) reported ECMM Diamond Excellence Status.
CONCLUSIONS
CONCLUSIONS
The results of this survey document the continuing need to improve the availability of specialised Medical Mycology support in German academic medical centres.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1177-1182Investigateurs
Sören L Becker
(SL)
Christoph Berg
(C)
Gerlinde Egerer
(G)
Helmut Fickenscher
(H)
Beatrice Grabein
(B)
Beate Gruener
(B)
Susanne Hauswaldt
(S)
Jürgen Held
(J)
Winfried Kern
(W)
Hans-Jürgen Laws
(HJ)
Thomas Lehrnbecher
(T)
Christoph Lübbert
(C)
Peter Rath
(P)
Bernd Salzberger
(B)
Enrico Schalk
(E)
Stefan Schwartz
(S)
Gerda Silling
(G)
Christoph Spinner
(C)
Maria Vehreschild
(M)
Marie von Lilienfeld-Toal
(MV)
Michael Weig
(M)
Informations de copyright
© 2021 The Authors. Mycoses published by Wiley-VCH GmbH.
Références
Brown GD, Denning DW, Gow NA, Levitz SM, Netea MG, White TC. Hidden killers: human fungal infections. Sci Transl Med. 2012;4(165):165rv13.
Ruhnke M, Groll AH, Mayser P, Ullmann A, Mendling W, Hof H, Denning DW. Estimated burden of fungal infections in Germany. Mycoses. 2015;58(Suppl 5):22-28.
von Lilienfeld-Toal M, Wagener J, Einsele H, Cornely OA, Kurzai O. Invasive fungal infections. Dtsch Arztebl Int. 2019;116(16):271-278.
Cole DC, Govender NP, Chakrabarti A, Sacarlal J, Denning DW. Improvement of fungal disease identification and management: combined health systems and public health approaches. Lancet Infect Dis. 2017;17(12):e412-e419.
McCarthy MW, Kontoyiannis DP, Cornely OA, Perfect JR, Walsh TJ. Novel agents and drug targets to meet the challenges of resistant fungi. J Infect Dis. 2017;216(suppl_3):S474-S483.
Perfect JR. The antifungal pipeline: a reality check. Nat Rev Drug Discov. 2017;16(9):603-616.
White LP, Price JS. Recent advances and novel approaches in laboratory-based diagnostic mycology. J Fungi (Basel). 2021;7(1):41.
Donnelly JP, Chen SC, Kauffman CA, et al. Revision and update of the consensus definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium. Clin Infect Dis. 2020;71(6):1367-1376.
Segal BH, Herbrecht R, Stevens DA, et al. Defining responses to therapy and study outcomes in clinical trials of invasive fungal diseases: Mycoses Study Group and European Organization for Research and Treatment of Cancer consensus criteria. Clin Infect Dis. 2008;47(5):674-683.
Cornely OA, Lass-Flörl C, Lagrou K, Arsic-Arsenijevic V, Hoenigl M. Improving outcome of fungal diseases - guiding experts and patients towards excellence. Mycoses. 2017;60(7):420-425.
European conference on infections in leukaemia. Publications. Available at: http://www.ecil-leukaemia.com/publications.htm. Accessed May 23, 2021.
Infectious Disease Society of America: practice guidelines. Available at: https://www.idsociety.org/practice-guideline/practice-guidelines/#/date_na_dt/DESC/0/+/. Accessed May 23, 2021.
Global Action Fund for Fungal Infections (GAFFI): our vision -a world free from death and suffering caused by fungal disease. Available at https://www.gaffi.org/. Accessed May 23, 2021.
United Nations Global Marketplace: support the development of the WHO fungal priority pathogens list of public health importance. Request for Proposals (RFP) Bid Reference AMR/GCP/2020/8. Available at https://www.ungm.org/Public/Notice/115405/. Accessed May 23, 2021.
Deutschsprachige Mykologische Gesellschaft e.V. (DMYKG). https://www.dmykg.de/. Accessed May 23, 2021.
Paul-Ehrlich-Gesellschaft für Chemotherapy e.V. (PEG) - Sektion Antimykotische Chemotherapie. https://www.p-e-g.org/sektion-antimykotische-chemotherapie.html. Accessed May 23, 2021.
Konsiliarlabor für Kryptokokkose und seltene Systemmykosen. Robert Koch Institut (RKI), Berlin: https://www.rki.de/DE/Content/Infekt/NRZ/Cryptococcus/Cryptococcus_node.html;jsessionid=88C6E41A953BDDFDCC9E4D7A395D1B69.internet111. Accessed May 23, 2021.
Verband der Universitätsklinika in Deutschland (VUD): Übersicht der Universitätsklinika in Deutschland. https://www.uniklinika.de/die-deutschen-universitaetsklinika/uebersicht-der-universitaetsklinika/. Accessed January 17, 2019.
QuestionPro: Rücklaufquoten bei Online-Umfragen: Definition, Berechnung, Einfluss-parameter & Best Practices. https://www.questionpro.group/responsequote-ruecklaufquote-online-umfrage/. Accessed May 23, 2021.
Ben-Ami R, Halaburda K, Klyasova G, Metan G, Torosian T, Akova M. A multidisciplinary team approach to the management of patients with suspected or diagnosed invasive fungal disease. J Antimicrob Chemother. 2013;68(suppl 3):iii25-iii33.
Janssen NAF, Brüggemann RJM, Reijers MH, et al. A multidisciplinary approach to fungal infections: one-year experiences of a center of expertise in mycology. J Fungi (Basel). 2020;6(4):274.
Walger P, Faetkenheuer G, Herrmann M, Liese J, Mertens T. Infektionsmedizin: Klinische Expertise fördern. Dtsch Arztebl. 2017;114:A-948/B-793/C-775.
124. Ärztetag (Online) 04. bis 05.05.2021. Beschlussprotokoll. https://www.bundesaerztekammer.de/aerztetag/124-deutscher-aerztetag-2021-als-online-veranstaltung/beschlussprotokoll/. Accessed 23 May, 2021.
Nationales Referenzzentrum für Invasive Pilzinfektionen (NRZMyk), Institut für Hygiene und Microbiologie, Universität Würzburg. https://www.nrz-myk.de/home.html. Accessed May 23, 2021.
Nationales Konsillabor für Dermatophyten, Institut für Mikrobiologie und Infektionsimmunologie, Charite Universitätsmedizin Berlin. https://imh.charite.de/leistungen/konsiliarlabor_dermatophyten/. Accessed May 23, 2021.
Hoenigl M, Gangneux JP, Segal E, et al.; European Confederation of Medical Mycology (ECMM). Global guidelines and initiatives from the European Confederation of Medical Mycology to improve patient care and research worldwide: new leadership is about working together. Mycoses. 2018;61(11):885-894.
Koehler P, Denis B, Denning DW, et al.; European Confederation of Medical Mycology (ECMM). European confederation of medical mycology expert consult-an ECMM excellence center initiative. Mycoses. 2020;63(6):566-572.