Diagnostic Capacity for Invasive Fungal Infections in the Greek Paediatric Haematology-Oncology Units: Report from the Infection Working Group of the Hellenic Society of Paediatric Haematology-Oncology
Abstract
:1. Introduction
2. Methods
3. Results
3.1. Culture Based Methods
3.2. Non-Culture-Based Methods
4. Discussion
Author Contributions
Funding
Conflicts of Interest
References
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Type of hospital: General Hospital □ University Hospital □ Other □ (please specify) Your region: Specialties served in your Unit: Oncology □ Haematology □ BMT/SCT □ Infectious diseases □ Other □ (please specify) Mean number of patients hospitalised per year: Please list the 5 most common diseases you have treated during the last 2 years: a., b., c., d., e. | |||
yes | no | ||
Culture based methods: | |||
1. | Ιs there the possibility to perform the following tests in your hospital/institution? | ||
a. | Cultures for fungal pathogens | ||
b. | Direct microscopy of the specimen | ||
c. | Phenotypic identification | ||
d. | Molecular identification | ||
e. | MALDI-TOF | ||
If any of the answers is no, do you refer the test to another external laboratory (reference laboratory, regional, private, abroad, other)? Please specify. | |||
2. | In case of a positive culture, is there the possibility for identification of the specific pathogens in your institution? | ||
a. | Candida spp. | ||
b. | Cryptococcus spp. | ||
c. | Other yeasts | ||
d. | Aspergillus spp. | ||
e. | Mucorales (Rhizopus spp., Mucor spp., etc) | ||
f. | Fusarium spp. | ||
g. | Acremonium /Sarocladium spp. | ||
h. | Scedosporium spp. | ||
i. | Other moulds | ||
If any of the answers is no, do you refer the test to another external laboratory (reference laboratory, regional, private, abroad, other)? Please specify. | |||
3. | Please specify how the identification is performed in your institution (Phenotypical, Molecular, MALDI-ToF) | ||
a. | Candida spp. | ||
b. | Cryptococcus spp. | ||
c. | Other yeasts | ||
d. | Aspergillus spp. | ||
e. | Mucorales (Rhizopus spp., Mucor spp.,etc) | ||
f. | Fusarium spp. | ||
g. | Acremonium/Sarocladium spp. | ||
h. | Scedosporium spp. | ||
i. | Other moulds | ||
If you refer any of the identification procedures, please specify (which one do you refer and to which type of laboratory-reference, regional, private, abroad, other) | |||
4. | Is there availability of antifungal susceptibility testing in your hospital/institution? | ||
a. | AFST for yeasts | ||
b. | AFST for moulds | ||
If any of the answers is no, do you refer the test to another external laboratory (reference laboratory, regional, private, abroad, other)? Please specify. | |||
5. | Which of the following invasive fungal infections have you been diagnosed with in the last 2 years? Please provide approximate number. | ||
a. | Invasive candidiasis | ||
b. | Aspergillosis | ||
c. | Mucormycosis | ||
d. | Fusariosis | ||
e | Pneumocystosis | ||
f. | Other (please specify) | ||
Non-culture based methods: | |||
6. | Is there the possibility to perform the following tests in your hospital/institutional laboratory? | ||
a. | Aspergillus galactomannan | ||
b. | 1, 3-β-D-glucan | ||
c. | Mannan | ||
d. | anti-Mannan | ||
e. | Antibodies against Aspergillus | ||
f. | Cryptococcus antigen (agglutination) | ||
g. | Cryptococcus antigen (lateral flow) | ||
h. | IFA for Pneumocytis jirovecii | ||
i. | PCR for: Aspergillus □ Candida □ Cryptococcus □ Pneumocystis jirovecii □ | ||
If any of the answers is no, do you refer the test to another external laboratory (reference laboratory, region, private, abroad, other)? Please specify. | |||
7. | Which of the following tests have you performed during the last 2 years? Please provide an approximate total number for the tests you have performed. If you referred to an external laboratory, please specify how many “in house” and how many externally. | ||
a. | Aspergillus galactomannan | ||
b. | 1,3-β-D-glucan | ||
c. | Mannan | ||
d. | anti-Mannan | ||
e. | Antibodies against Aspergillus | ||
f. | Cryptococcus antigen (agglutination) | ||
g. | Cryptococcus antigen (lateral flow) | ||
h. | IFA for Pneumocytis jirovecii | ||
i. | PCR for: Aspergillus □ Candida □ Cryptococcus □ Pneumocystis jirovecii □ | ||
8. | What is the turnaround time for the aforementioned tests? | ||
a. | Aspergillus galactomannan 0–48 h □ 48 h–1 week □>1 week □ | ||
b. | β-D-Glucan 0–48 h □ 48 h–1 week □>1 week □ | ||
c. | Mannan 0–48 h □ 48 h–1 week □>1 week □ | ||
d. | anti-Mannan 0–48 h □ 48 h–1 week □>1 week □ | ||
e. | Antibodies against Aspergillus 0–48 h □ 48 h–1 week □>1 week □ | ||
f. | Cryptococcus antigen (agglutination) 0–48 h □ 48 h–1 week □>1 week □ | ||
g. | Cryptococcus antigen (lateral flow) 0–48 h □ 48 h–1 week □>1 week □ | ||
h. | Aspergillus PCR 0–48 h □ 48 h–1 week □>1 week □ | ||
i. | IFA for Pneumocytis jirovecii 0–48 h □ 48 h–1 week □>1 week □ | ||
j. | Candida PCR 0–48 h □ 48 h–1 week □>1 week □ | ||
k. | Cryptococcus PCR 0–48 h □ 48 h–1 week □>1 week □ | ||
l. | Pneumocystis PCR 0–48 h □ 48 h–1 week □>1 week □ | ||
9. | Is there the possibility to perform TDM for the following antifungal agents? “In house” or externally? Please specify. | ||
a. | voriconazole | ||
b. | posaconazole | ||
c. | isavuconazole | ||
d. | itraconazole | ||
e. | 5-FC | ||
10. | Do you believe that TDM is useful for the treatment of your patients? Please comment. | ||
11. | What treatment strategy do you usually apply? | ||
Empirical □ Pre-emptive □ Targeted □ |
Mycoses | Total Number |
---|---|
Candidiases | 15–17 |
Aspergilloses | 17–18 |
Mucormycoses | 4 |
Fusarioses | 4 |
Pneumocystoses | 2 |
Trichosporoses | 1 |
Unit | Capacity of the Host Hospital’s Laboratory | Refers to An External Laboratory | Type of Laboratory of Reference | |||
---|---|---|---|---|---|---|
AFST | TDM * | AFST | TDM * | AFST | TDM * | |
1 | Only yeasts | No | Yes (moulds) | Yes | Private | Private |
2 | Only yeasts | No | Yes (moulds) | Yes | University | University, Other Hospital, Private |
3 | Yes | No | No | Yes | - | University, Private |
4 | Yes | No | No | No | - | - |
5 | Yes | No | Yes (if necessary) | Yes | University | University |
6 | Yes | No | No | Yes | - | Private |
7 | Yes | No | No | Yes | - | University, Private |
8 | Yes | Yes | No | No | - | - |
Diagnostic Tests | Number of Host Hospitals’ Laboratories that Perform the Test | Number of Tests Performed during the Two Years Per Unit |
---|---|---|
Aspergillus galactomannan | 2/8 | 20–100 |
1,3-β-D-glucan | 1/8 | 5–80 |
mannan | 0/8 | 0–100 |
Anti-mannan | 0/8 | 0–20 |
Antibodies against Aspergillus | 1/8 | 0–20 |
Cryptococcus antigen (agglutination) | 2/8 | 0–20 |
Cryptococcus antigen (lateral flow) | 2/8 | 0–10 |
IFA for Pneumocystis jirovecii | 1/8 | 0–5 |
PCR for: | ||
Aspergillus | 2/8 | 6–100 |
Candida | 2/8 | 10–100 |
Cryptococcus | 2/8 | 0 |
Pneumocystis jirovecii | 0/8 | 2–5 |
0–48 h | 48 h–1 week | >1 week | |
---|---|---|---|
Aspergillusgalactomannan | 3/8 | 4/8 | 1/8 |
β-D-glucan | 3/8 | 4/8 | 1/8 |
mannan | 2/6 * | 3/6 * | 1/6 * |
anti-mannan | 2/5 * | 2/5 * | 1/5 * |
antibodies against Aspergillus | 4/5 * | 1/5 * | |
Cryptococcus antigen (agglutination) | 2/6 * | 4/6 * | |
Cryptococcus antigen (lateral flow) | 2/5 * | 3/5 * | |
IFA for Pneumocystis jirovecii | 2/6 * | 4/6 * | |
Aspergillus PCR | 2/8 | 6/8 | |
Candida PCR | 2/8 | 6/8 | |
Cryptococcus PCR | 2/6 * | 4/6 * | |
Pneumocystis PCR | 1/7 * | 6/7 * |
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Markantonatou, A.-M.; Tragiannidis, A.; Galani, V.; Doganis, D.; Antoniadi, K.; Tsipou, H.; Lambrou, M.; Katzilakis, N.; Paisiou, A.; Palabougiouki, M.; et al. Diagnostic Capacity for Invasive Fungal Infections in the Greek Paediatric Haematology-Oncology Units: Report from the Infection Working Group of the Hellenic Society of Paediatric Haematology-Oncology. J. Fungi 2021, 7, 357. https://doi.org/10.3390/jof7050357
Markantonatou A-M, Tragiannidis A, Galani V, Doganis D, Antoniadi K, Tsipou H, Lambrou M, Katzilakis N, Paisiou A, Palabougiouki M, et al. Diagnostic Capacity for Invasive Fungal Infections in the Greek Paediatric Haematology-Oncology Units: Report from the Infection Working Group of the Hellenic Society of Paediatric Haematology-Oncology. Journal of Fungi. 2021; 7(5):357. https://doi.org/10.3390/jof7050357
Chicago/Turabian StyleMarkantonatou, Anthi-Marina, Athanasios Tragiannidis, Vasiliki Galani, Dimitrios Doganis, Kondilia Antoniadi, Haroula Tsipou, Maria Lambrou, Nikolaos Katzilakis, Anna Paisiou, Maria Palabougiouki, and et al. 2021. "Diagnostic Capacity for Invasive Fungal Infections in the Greek Paediatric Haematology-Oncology Units: Report from the Infection Working Group of the Hellenic Society of Paediatric Haematology-Oncology" Journal of Fungi 7, no. 5: 357. https://doi.org/10.3390/jof7050357