EQUAL Fusariosis score 2021: An European Confederation of Medical Mycology score derived from current guidelines to measure QUALity of the clinical management of invasive fusariosis

Abstract

Background Invasive fusariosis is a serious infection affecting mostly patients with haematologic malignancies and hematopoietic cell transplant recipients. Objectives To develop a scoring tool that evaluates guideline adherence in the management of invasive fusariosis. Methods We reviewed two guidelines, provided by the European Society for Clinical Microbiology and Infectious Diseases (ESCMID) and the European Confederation of Medical Mycology (ECMM), and selected the strongest recommendations for management quality as the bases for the scoring tool. Results We reviewed the recommendations regarding primary and secondary prophylaxis, diagnostics procedures (images, blood cultures, biopsy of skin lesions with direct examination, culture and histopathology, species identification, antifungal susceptibility tests and antigen detection), treatment choices and follow‐up procedures. The tool comprises 18 items, with a maximum of 24 points. Conclusions The EQUAL score Fusariosis is a tool that may help clinicians to measure guidelines adherence.

Invasive Fusariosis in Patients with Hematologic Diseases

“…Recently, the European Confederation of Medical Mycology (ECMM) together with the International Society for Human and Animal Mycology (ISHAM) and the American Society for Microbiology (ASM) published guidelines for the management of rare moulds, including fusariosis, containing recommendations for the diagnosis, prevention and treatment of fusariosis [78]. We developed an 18-item tool that gathers the most relevant recommendations from these guidelines, and may help clinicians and institutions to quantify the quality of care of immunocompromised patients who develop invasive fusariosis [83].…”

EQUAL CPA Score 2022: a tool to measure guideline adherence for chronic pulmonary aspergillosis

“…Equivalent to the other EQUAL scores, this tool was designed as a bedside instrument for selfassessment of management quality and to support antifungal stewardship. [14][15][16][17][18][19][20] One of the main objectives of CPA management is to reliably diagnose or rule out CPA when clinically suspected. A multidisciplinary team conference between healthcare professionals with different medical expertise is crucial for obtaining consensus on the appropriate diagnostic and therapeutic approaches in difficult to manage fungal infections.…”

“…Currently, EQUAL scores are available for candidemia, invasive aspergillosis, cryptococcosis, mucormycosis, fusariosis, Scedosporium-, Lomentospora-and Trichosporon-associated infections. [14][15][16][17][18][19][20] In several subsequent studies, guideline adherence correlated with patient outcome. [21][22][23][24][25][26][27] Here, we present an EQUAL Score weighing recommendations from current guidelines for the management of CPA.…”