Survey of laboratory practices for diagnosis o f fungal infection in seven Asian countries: An Asia Fungal Working Group (AFWG) initiative
Survey of laboratory practices for diagnosis o f fungal infection in seven Asian countries: An Asia Fungal Working Group (AFWG) initiative
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DOI：
10.1093/mmy/myx066
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发表时间：
2018-06-01
期刊：
影响因子：
2.9
通讯作者：
Chayakulkeeree, Methee
中科院分区：
文献类型：
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作者：
Chindamporn, Ariya;Chakrabarti, Arunaloke;Chayakulkeeree, Methee
对七个亚洲国家的真菌学实验室进行了在线调查，以评估其现状、能力和可用的服务。来自亚洲真菌工作组(AFWG)的国家代表联系了各自国家尽可能多的进行真菌学诊断的实验室，要求实验室负责人完成在线调查。共有241家实验室做出回应，其中中国71家、印度104家、印度尼西亚11家、菲律宾26家、新加坡4家、台湾18家、泰国7家。总体而言，129/241(53.5%)的真菌学实验室作为独立的指定真菌学实验室运作，75/241(31.1%)进行定期的正式工作人员培训，103/241(42.7%)获得认证，88/157(56.1%)参与外部质量保证计划(EQAS)。几乎所有实验室都提供显微镜和培养方法，但很少有实验室进行DNA测序(37/219；16.9%)或使用基质辅助激光解吸/电离飞行时间质谱仪(MALDI-TOF MS)(27/219；12.3%)进行分离鉴定。142/241(58.9%)的实验室进行了抗真菌药敏试验，主要是酵母菌。最常见的非培养诊断是隐球菌抗原检测(66个实验室)，其次是半乳甘露聚糖检测(55个)、聚合酶链式反应(PCR)诊断(37个)和β-D-葡聚糖检测(24个)。治疗药物监测在21个实验室进行。在印度尼西亚、菲律宾和泰国接受调查的实验室中，几乎无法获得先进的诊断测试，如半乳甘露聚糖、β-D-葡聚糖和聚合酶链式反应。这些结果突出表明，需要发展高质量的实验室，对现有实验室的人力进行认证和培训，并获得先进的非培养诊断测试，以促进亚洲真菌感染的诊断。
An online survey of mycology laboratories in seven Asian countries was conducted to assess the status, competence, and services available. Country representatives from the Asia Fungal Working Group (AFWG) contacted as many laboratories performing mycology diagnosis as possible in their respective countries, requesting that the laboratory heads complete the online survey. In total, 241 laboratories responded, including 71 in China, 104 in India, 11 in Indonesia, 26 in the Philippines, four in Singapore, 18 in Taiwan, and seven in Thailand. Overall, 129/241 (53.5%) surveyed mycology laboratories operate as separate designated mycology laboratories, 75/241 (31.1%) conduct regular formal staff training, 103/241 (42.7%) are accredited, and 88/157 (56.1%) participate in external quality assurance scheme (EQAS) programs. Microscopy and culture methods are available in nearly all laboratories, although few perform DNA sequencing (37/219; 16.9%) or use matrix-assisted laser desorption/ionization time-of-flight mass spectroscopy (MALDI-TOF MS) (27/219; 12.3%) for isolate identification. Antifungal susceptibility testing is performed in 142/241 (58.9%) laboratories, mainly for yeasts. The most commonly performed nonculture diagnostic is cryptococcal antigen testing (66 laboratories), followed by galactomannan testing (55), polymerase chain reaction (PCR) diagnosis (37), and beta-D-glucan testing (24). Therapeutic drug monitoring is conducted in 21 laboratories. There is almost no access to advanced diagnostic tests, like galactomannan, beta-D-glucan, and PCR, in the surveyed laboratories in Indonesia, the Philippines, and Thailand. These results highlight the need for development of quality laboratories, accreditation and training of manpower in existing laboratories, and access to advanced non-culture-based diagnostic tests to facilitate the diagnosis of fungal infections in Asia.