Journal of Microbiology, Immunology and Infection ( IF 7.4 ) Pub Date : 2020-03-27 , DOI: 10.1016/j.jmii.2020.03.016 He Wang , Yao Wang , Qi-Wen Yang , Yu-Xing Ni , Li-Kai Lin , Yan-Ping Luo , Zi-Yong Sun , Min Li , Wen-Juan Wu , Qiang-Qiang Zhang , Dan-Hong Su , Hua Yu , Mei Kang , He-Ping Xu , Wei Liu , Qing Yang , Cui Jian , Li-Na Guo , Wen-Hang Yang , Meng Xiao , Po-Ren Hsueh , Ying-Chun Xu
Background/purpose
As the incidence of fungal infections in China increases, the demand for rapid and accurate diagnosis of mycoses is growing. Yet, information on current diagnostic capacity is scarce.
Methods
An online survey was conducted in February 2018 to collect information on mycology testing from tertiary care hospitals across China. Responses from 348 hospitals were analyzed, and a scoring system was designed and employed to assess the overall diagnostic capacity.
Results
Most of the surveyed hospitals did not have separate laboratory space, manpower, or equipment dedicated for fungal testing. Conventional staining methods were widely available (>70%), whereas GMS and fluorescent staining were less common. Fungal identification services were offered mostly with chromogenic medium, morphological characterization or automated identification systems, other than more advanced methods such as MALDI-TOF MS and DNA sequencing. Fungal serology testing was available in 81.1%, with G test being the most often used. Though 91.8% of the respondents had the ability to perform antifungal susceptibility testing for yeasts, less than 13% conducted such testing for molds. The percentage of laboratories participating in External Quality Assessment programs and research was 57.5% and 32.5%, respectively. The average score for the 348 surveyed hospitals was 37.2 (out of a maximum of 89 points), with only 15 hospitals scoring >60, suggesting a general lack of high-quality mycology laboratories.
Conclusions
The overall clinical testing capacity for fungal infection in China is insufficient. More investment and training efforts are warranted to establish centers of excellence and promote access to high-quality diagnostic services.