Multicentric Study on the Clinical Mycology Capacity and Access to Antifungal Treatment in Portugal.
Antifungals
Clinical mycology
Diagnosis
Invasive fungal disease
Portugal
Therapy
Journal
Mycopathologia
ISSN: 1573-0832
Titre abrégé: Mycopathologia
Pays: Netherlands
ID NLM: 7505689
Informations de publication
Date de publication:
24 Jan 2024
24 Jan 2024
Historique:
received:
19
10
2023
accepted:
04
01
2024
medline:
24
1
2024
pubmed:
24
1
2024
entrez:
24
1
2024
Statut:
epublish
Résumé
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.
Identifiants
pubmed: 38265528
doi: 10.1007/s11046-024-00830-9
pii: 10.1007/s11046-024-00830-9
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
15Subventions
Organisme : Fundação para a Ciência e a Tecnologia
ID : CEECIND/04058/2018
Organisme : Fundação para a Ciência e a Tecnologia
ID : 2022.12062.BD
Investigateurs
Joana Batista
(J)
Dinah Carvalho
(D)
Adriana Coutinho
(A)
Flávia Cunha
(F)
Augusta Gonçalves
(A)
Catarina Gouveia
(C)
António Guerra Maio
(A)
Augusto Machado E Costa
(A)
Dolores Pinheiro
(D)
Pedro Póvoa
(P)
Elmano Ramalheira
(E)
Valentina Santos
(V)
Ana Cristina Silva
(AC)
Zélia Videira
(Z)
Informations de copyright
© 2024. The Author(s).
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