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. 2023 Jun 5;61(6):myad058.
doi: 10.1093/mmy/myad058.

The Argentinian landscape of mycological diagnostic capacity and treatment accessibility

Fernando Riera  1   2 , Juan Pablo Caeiro  2   3 , Oliver A Cornely  4   5   6   7 , Jon Salmanton-García  4   5   6 ; Argentinian IFI diagnostic and treatment capacity group
Collaborators, Affiliations

The Argentinian landscape of mycological diagnostic capacity and treatment accessibility

Fernando Riera et al. Med Mycol. .

Abstract

Immunosuppressed patients, transplant recipients, and those with acute or chronic respiratory disease are at increased risk for invasive fungal infections in Argentina. Although the national public system guarantees universal access to health care for all citizens, little is known about the quality of available diagnostic and treatment armamentaria for invasive fungal infections in the country. Between June and August 2022, infectious disease clinicians from each of the 23 provinces and the Autonomous City of Buenos Aires were contacted to describe local access to fungal diagnostic tools and antifungal agents. The information collected included different aspects such as hospital characteristics, patients admitted and wards, access to diagnostic tools, estimated infection incidence, and treatment capacity. Thirty responses were collected from facilities throughout Argentina. Most institutions were governmental (77%). A mycology department was available in 83% of them. Histopathology was available in almost 93% of the sites, while automated methods and galactomannan tests were available in 57%, each; 53% of the sites had access to MALDI-TOF-MS through regional reference laboratories, and PCR was present in 20% of the sites. Susceptibility testing was available in 63% of the laboratories. Candida spp. (24%), Cryptococcus spp. (20%), Aspergillus spp. (18%), and Histoplasma spp. (16%) were described as the main pathogens. Fluconazole was the only antifungal agent available in all institutions. This was followed by amphotericin B deoxycholate (83%) and itraconazole (80%). If an antifungal agent was not available onsite, then 60% of the patients could receive adequate antifungal treatment within the first 48 h upon request. Although there are no significant differences in access to diagnostic and clinical management of invasive fungal infections among the Argentinean centres studied, national awareness-raising initiatives led by policymakers could help to improve their general availability.

Keywords: Argentina; antifungals; antigen; culture; diagnostic capacity; microscopy; molecular test; mycology; serology.

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Conflict of interest statement

F.R. reports grants from Gador, Gilead, and Knight Tx, outside the submitted work.

O.A.C. reports grants or contracts from Amplyx, Basilea, BMBF, Cidara, DZIF, EU-DG RTD (101037867), F2G, Gilead, Matinas, MedPace, MSD, Mundipharma, Octapharma, Pfizer, Scynexis; consulting fees from Amplyx, Biocon, Biosys, Cidara, Da Volterra, Gilead, Matinas, MedPace, Menarini, Molecular Partners, MSG-ERC, Noxxon, Octapharma, PSI, Scynexis, Seres; honoraria for lectures from Abbott, Al-Jazeera Pharmaceuticals, Astellas, Grupo Biotoscana/United Medical/Knight, Hikma, MedScape, MedUpdate, Merck/MSD, Mylan, Pfizer; payment for expert testimony from Cidara; participation on a Data Safety Monitoring Board or Advisory Board from Actelion, Allecra, Cidara, Entasis, IQVIA, Janssen, MedPace, Paratek, PSI, Shionogi; a patent at the German Patent and Trade Mark Office (DE10 2021113007.7), all outside of the submitted work.

J.S.G. reports speaker honoraria from Gilead and Pfizer, outside of the submitted work.

Figures

Figure 1.
Figure 1.
Map of participating institutions per province.
Figure 2.
Figure 2.
Fungal incidence distribution.
See this image and copyright information in PMC

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