Mapping the path to excellence: Evaluation of the diagnostic and treatment tools for invasive fungal infections in the balkans

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES Journal of Infection and Public Health Pub Date : 2024-07-06 DOI:10.1016/j.jiph.2024.102493

Nikola Pantić , Aleksandra Barać , Vasilika Mano , Amela Dedeić-Ljubović , Ivan Malkodanski , Ozren Jaksić , Despoina Gkentzi , Mirjana Mitrović , Oxana Munteanu , Dijana Šišević , Zlate Stojanoski , Oana Popescu , Jelena Todorović , Oliver A. Cornely , Jon Salmanton-García

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Abstract

Background

In the Balkans, rising concerns about invasive fungal infections over the past decade stem from various factors. Primarily, there has been a notable uptick in immunocompromised individuals, including those with chronic illnesses like immunological and hematological diseases. Thus, it is essential to assess the region's laboratory capabilities and the availability of antifungals. This evaluation is vital for gauging the preparedness to diagnose and treat fungal infections effectively, thus minimizing their public health impact.

Methods

Data were collected via an online questionnaire targeting healthcare professionals specializing in relevant fields across diverse healthcare settings in Balkan countries. The survey covered various aspects, including diagnostic methods, imaging techniques, and available antifungal armamentarium.

Results

Responses were obtained from 50 institutions across the Balkans. While conventional diagnostic methods like microscopy (96 %) and culture (100 %) diagnostics were widely available, access to newer diagnostic tools such as molecular assays (61 %) were limited, often relying on outsourced services. Imaging modalities like ultrasound (100 %) and CT scans (93 %) were universally accessible. A variety of antifungal drugs were available, including amphotericin B formulations (80 %), echinocandins (79 %), and triazoles (100 %). However, access to newer agents like posaconazole (62 %) and isavuconazole (45 %) was inconsistent. Therapeutic drug monitoring (53 %) services were also limited.

Conclusion

The study underscores the need for equitable access to diagnostic facilities and antifungal treatments across healthcare settings in the Balkan geographic region. Improving access to molecular diagnostic tools and essential antifungal drugs, as well as implementing therapeutic drug monitoring, would optimize the management of fungal infections in the region.

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绘制卓越之路：评估巴尔干地区侵袭性真菌感染的诊断和治疗工具。

背景：在巴尔干地区，过去十年来人们对侵袭性真菌感染的关注日益增加，这源于各种因素。主要原因是免疫力低下的人明显增多，包括患有免疫病和血液病等慢性疾病的人。因此，评估该地区的实验室能力和抗真菌药物供应情况至关重要。这项评估对于衡量有效诊断和治疗真菌感染的准备情况至关重要，从而将真菌感染对公共卫生的影响降至最低：方法：通过在线问卷调查收集数据，调查对象为巴尔干国家不同医疗机构中相关领域的专业医护人员。调查涉及各个方面，包括诊断方法、成像技术和现有的抗真菌设备：结果：巴尔干地区的 50 家机构提供了答复。虽然显微镜（96%）和培养（100%）等传统诊断方法已广泛使用，但分子检测（61%）等新型诊断工具的使用却很有限，通常依赖于外包服务。超声波（100%）和 CT 扫描（93%）等成像方式已普及。抗真菌药物种类繁多，包括两性霉素 B 制剂（80%）、棘白菌素类（79%）和三唑类（100%）。然而，新药如泊沙康唑（62%）和异武康唑（45%）的供应并不稳定。治疗药物监测服务（53%）也很有限：这项研究强调了在巴尔干地区的各种医疗机构中公平使用诊断设施和抗真菌治疗的必要性。改善分子诊断工具和基本抗真菌药物的获取，以及实施治疗药物监测，将优化该地区真菌感染的管理。

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.