ESCMID‐EFISG Survey on Diagnostic and Therapeutic Capacity for Invasive Fungal Infections in Belgium, the Netherlands, and Luxembourg: A Focus on High Azole Resistance
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| Titel: | ESCMID‐EFISG Survey on Diagnostic and Therapeutic Capacity for Invasive Fungal Infections in Belgium, the Netherlands, and Luxembourg: A Focus on High Azole Resistance |
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| Autoren: | Aerts, Robina, Cuypers, Lize, Meijer, Eelco F. J., Kohnen, Michel, Meis, Jacques F., Cornely, Oliver A., Lagrou, Katrien, Salmanton‐García, Jon, Wagemakers, Alex, Vestjens, Stefan, Verbeeck, Peter, Vanheule, Geert, Vandevelde, Marc, van Van Praet, Jens, van Van Herendael, Bruno, van Doesum, Jaap, van Van Dijk, Karin, van der Van der Hoeven, Alieke, van de Van de Sande, Wendy W. J., Reynders, Marijke, Packeu, Ann, Overmeire, Yarah, Oliveira‐dos‐Santos, Claudy, Nulens, Eric, Mzabi, Alexandre, Muyldermans, Astrid, Montesinos, Isabel, Melchers, Willem, Maertens, Johan, Maelegheer, Karel, Lekkerkerk, Sybren, Layios, Nathalie, Kolwijck, Eva, Jonckheere, Stijn, Ide, Louis, Hayette, Marie‐Pierre, Hagen, Ferry, Haas, Pieter‐Jan, Goegebuer, Truus, Godschalk, Peggy, de Moreau, Anne‐Isabelle, de Laere, Emmanuel, de Greef, Julien, de Geyter, Deborah, Croughs, Peter, Clevenbergh, Philippe, Claessens, Jolien, Chong, Ga‐Lai, Cartuyvels, Reinoud, Buil, Jochem, Bruggemann, Roger, Boelens, Jerina, Boel, An, Bentvelsen, Robbert |
| Quelle: | Mycoses Mycoses, 68, 7 |
| Verlagsinformationen: | Wiley, 2025. |
| Publikationsjahr: | 2025 |
| Schlagwörter: | Medical Microbiology - Radboud University Medical Center, Azoles, Male, Antifungal Agents, MEDICAL MYCOLOGY, Luxembourg, Luxembourg/epidemiology, Laboratory medicine & medical technology, Belgium, Surveys and Questionnaires, Human health sciences, lateral flow devices, Netherlands, Incidence, antifungal resistance, Middle Aged, ASPERGILLUS-FUMIGATUS, PREVALENCE, Médecine de laboratoire & technologie médicale, Antifungal Agents/pharmacology, Antifungal Agents/therapeutic use, Female, Original Article, Azoles/therapeutic use, Drug Monitoring, Life Sciences & Biomedicine, azole-resistance, Adult, Invasive Fungal Infections/drug therapy, Netherlands/epidemiology, Aspergillus fumigatus/drug effects, Dermatology, Mycology, Microbial Sensitivity Tests, Sciences de la santé humaine, Microbiology, azole‐resistance, Invasive Fungal Infections/microbiology, Drug Resistance, Fungal, MANAGEMENT, Humans, Belgium/epidemiology, Aged, invasive aspergillosis, Science & Technology, invasive fungal infections, Azoles/pharmacology, Aspergillus fumigatus, 3202 Clinical sciences, 1103 Clinical Sciences, lateral flow assays, Aspergillus fumigatus/isolation & purification, mycology, EUROPEAN CONFEDERATION, Invasive Fungal Infections/epidemiology, aspergillus antigen, Invasive Fungal Infections/diagnosis, Invasive Fungal Infections |
| Beschreibung: | IntroductionInvasive fungal infections (IFI) are a major clinical challenge, particularly in immunocompromised patients, and are associated with high morbidity and mortality. With the increasing prevalence of immunosuppressive conditions and ageing populations, the incidence of IFI is rising globally.ObjectiveThis survey aims to evaluate the diagnostic and therapeutic capacities for IFI in Belgium, the Netherlands, and Luxembourg (Benelux), a region of high azole‐resistance among Aspergillus fumigatus isolates.MethodsA survey evaluating the diagnostic and therapeutic capacity for IFI was conducted in the Benelux. Data were collected from specialists via an online case report form between March and September 2023. The survey addressed patient characteristics, access to microbiology labs, diagnostic methods (microscopy, culture, molecular diagnostics, etc.), IFI incidence, and the availability of antifungal drugs and therapeutic drug monitoring.ResultsIn total, 32 hospitals responded to the questionnaire (12 [38%] from the Netherlands, 19 [59%] from Belgium and one [3%] from Luxembourg). Antifungal susceptibility tests were available in 29 institutions (91%), constituting 84% of the centres in Belgium and 100% for the Netherlands (p = 0.265). Aspergillus PCR testing was available in 12 centres in Belgium (63%) while in 11 centres in the Netherlands (92%, p = 0.108). Mucorales PCR testing was available in 56% of centres. Treatment with at least one amphotericin B formulation was only available in 84% of the responding centres. Therapeutic drug monitoring (TDM), although recommended, was possible for voriconazole in 26 centres (81%) while for posaconazole in 24 centres (75%). Significantly more testing (diagnostic tests and TDM) was outsourced in Belgium compared to the Netherlands (p ConclusionsAntifungal susceptibility testing is widely available in Belgium and the Netherlands, but implementation in areas with high azole resistance for Aspergillus fumigatus is not yet universal, and techniques vary. Tests for coinfections, like Mucorales PCR, were only available in half of the centres. More testing is outsourced in Belgium, likely due to differences in reference centre organisation, country size, transport, and reimbursement. Delays in diagnosis can impact patient outcomes, so awareness of test availability and transport times is crucial. |
| Publikationsart: | Article Other literature type |
| Sprache: | English |
| ISSN: | 1439-0507 0933-7407 |
| DOI: | 10.1111/myc.70092 |
| Zugangs-URL: | https://hdl.handle.net/2066/321728 |
| Rights: | CC BY |
| Dokumentencode: | edsair.doi.dedup.....cc4365a66eb236ca967b58cf6fa1da0b |
| Datenbank: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstract: | IntroductionInvasive fungal infections (IFI) are a major clinical challenge, particularly in immunocompromised patients, and are associated with high morbidity and mortality. With the increasing prevalence of immunosuppressive conditions and ageing populations, the incidence of IFI is rising globally.ObjectiveThis survey aims to evaluate the diagnostic and therapeutic capacities for IFI in Belgium, the Netherlands, and Luxembourg (Benelux), a region of high azole‐resistance among Aspergillus fumigatus isolates.MethodsA survey evaluating the diagnostic and therapeutic capacity for IFI was conducted in the Benelux. Data were collected from specialists via an online case report form between March and September 2023. The survey addressed patient characteristics, access to microbiology labs, diagnostic methods (microscopy, culture, molecular diagnostics, etc.), IFI incidence, and the availability of antifungal drugs and therapeutic drug monitoring.ResultsIn total, 32 hospitals responded to the questionnaire (12 [38%] from the Netherlands, 19 [59%] from Belgium and one [3%] from Luxembourg). Antifungal susceptibility tests were available in 29 institutions (91%), constituting 84% of the centres in Belgium and 100% for the Netherlands (p = 0.265). Aspergillus PCR testing was available in 12 centres in Belgium (63%) while in 11 centres in the Netherlands (92%, p = 0.108). Mucorales PCR testing was available in 56% of centres. Treatment with at least one amphotericin B formulation was only available in 84% of the responding centres. Therapeutic drug monitoring (TDM), although recommended, was possible for voriconazole in 26 centres (81%) while for posaconazole in 24 centres (75%). Significantly more testing (diagnostic tests and TDM) was outsourced in Belgium compared to the Netherlands (p ConclusionsAntifungal susceptibility testing is widely available in Belgium and the Netherlands, but implementation in areas with high azole resistance for Aspergillus fumigatus is not yet universal, and techniques vary. Tests for coinfections, like Mucorales PCR, were only available in half of the centres. More testing is outsourced in Belgium, likely due to differences in reference centre organisation, country size, transport, and reimbursement. Delays in diagnosis can impact patient outcomes, so awareness of test availability and transport times is crucial. |
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| ISSN: | 14390507 09337407 |
| DOI: | 10.1111/myc.70092 |