背景:亚太地区的侵袭性真菌感染(FI)对恶性肿瘤患者构成威胁,不受控制的糖尿病或未诊断/未治疗的人类免疫缺陷病毒感染和获得性免疫缺陷综合征(HIV/AIDS)。充分和早期使用诊断工具和抗真菌药物对于国际金融机构的临床管理和患者生存至关重要。
方法:调查收集了有关机构概况的详细信息,对FI的自我感知,并获得显微镜,文化,血清学,抗原检测,分子检测,和治疗药物监测。
结果:截至2022年6月,来自亚太地区40个国家/地区的235个中心回答了问卷。其中一半以上来自六个国家:印度(25%),中国(17%),泰国(5%)印度尼西亚,伊朗,和日本(4%,each).念珠菌属。(93%)和曲霉属。(75%)被认为是最相关的病原体。大多数机构都可以使用显微镜(98%)或基于文化的方法(97%)。此外,其中79%有抗原检测,66%的分子检测,和63%的抗体测试。各国/地区之间获得抗真菌药物的机会各不相同。93%的报告地点至少有一种三唑(伏立康唑[89%]是最常见的霉菌活性唑),而80%的人至少有一种两性霉素B制剂,和72%的至少一种棘白菌素。
结论:目前,根据提供的答复,在亚洲/太平洋国家/地区,用于国际金融机构诊断和管理的资源各不相同。经济或地理因素可能在这种疾病负担的发生率和临床处理中起关键作用。区域合作可能是克服缺点的好战略。
BACKGROUND: Invasive fungal infections (IFIs) in Asia/Pacific are a particular threat to patients with malignancies, uncontrolled diabetes mellitus or undiagnosed/untreated human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS). Adequate and early access to diagnostic tools and antifungals is essential for IFI clinical management and patient survival.
METHODS: Details on institution profile, self-perception on IFI, and access to microscopy, culture, serology, antigen detection, molecular testing, and therapeutic drug monitoring for IFI were collected in a survey.
RESULTS: As of June 2022, 235 centres from 40 countries/territories in Asia/Pacific answered the questionnaire. More than half the centres were from six countries: India (25%),
China (17%), Thailand (5%), Indonesia, Iran, and Japan (4% each). Candida spp. (93%) and Aspergillus spp. (75%) were considered the most relevant pathogens. Most institutions had access to microscopy (98%) or culture-based approaches (97%). Furthermore, 79% of centres had access to antigen detection, 66% to molecular assays, and 63% to antibody tests. Access to antifungals varied between countries/territories. At least one triazole was available in 93% of the reporting sites (voriconazole [89%] was the most common mould-active azole), whereas 80% had at least one amphotericin B formulation, and 72% had at least one echinocandin.
CONCLUSIONS: According to the replies provided, the resources available for IFI diagnosis and management vary among Asia/Pacific countries/territories. Economical or geographical factors may play a key role in the incidence and clinical handling of this disease burden. Regional cooperation may be a good strategy to overcome shortcomings.