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

An audit based on a specific questionnaire was attempted, in order to investigate the mycology laboratory diagnostic capacity for invasive fungal diseases (IFDs) in Greek Paediatric Haematology-Oncology departments/units. The study provided the relevant information for the years 2019 and 2020 and included data from all units, concerning culture-based methods and direct microscopy, phenotypic and molecular identification, sensitivity testing, serology and molecular diagnosis, as well as therapeutic drug monitoring. The target was mostly to reveal the level of laboratory coverage for hospitalised paediatric patients, independently of the possibility of performing the tests in the host hospital, or otherwise to refer the specimens elsewhere. In total, the current study demonstrated that the most important facilities and services regarding the IFD diagnostics for paediatric haematology-oncology patients in Greece are available and relatively easily accessible, with a reasonable turnaround time. Acting as an initial registry for further improvements, the audit can serve as a valuable approach to the actual situation and future perspectives. A national clinical mycology network under the auspices of the relevant scientific societies will probably facilitate collaboration between all the departments (clinical and laboratory) involved in invasive fungal infections and provide an easier approach to any necessary test for any hospitalised patient.

The current state of laboratory mycology and access to antifungal treatment in Europe: a European Confederation of Medical Mycology survey

“…Similar studies have been performed before, although restricted to national experiences. 19,20 To the best of our knowledge, this is the first time that the mycological diagnostic capability and access to antifungal treatments of institutions has been evaluated at a pan-European level.…”

Invasive Fungal Infections in Children with Hematological Malignancy

“…2 Markantonatu et al had found Candida, Aspergillosis, Mucormycosis in15-17, 17-18, 4 cases in Greek children with malignancy. 15 Baytan et al also found 23 patients 14.3%) with IFI in their study. Ten children had proven and 13 children had probable IFI with F/M: 12/11.…”

Invasive Fungal Infections in Children with Haematological Malignancies: Diagnostic and Therapeutic Challenges

“…Apart from of the usefulness of a fungal biomarker such as mannan, galactomannan or β-D-glucan, or a molecular approach such as PCR for Aspergillus or Candida , there are specific difficulties in sampling, both culture and microscopy, which should always be attempted prior to the initiation of the antifungal treatment. Of course, as innovative methodologies are validated and information is arising in relation to specific fungal pathogens and groups of pediatric patients, the more all of these laboratory approaches are able to contribute to diagnosis and targeted treatment [ 1 , 7 ].…”