Laboratory and clinical management capacity for invasive fungal infections: the Italian landscape

Antonio Vena, Matteo Bassetti, Laura Mezzogori, Francesco Marchesi, Martin Hoenigl, Daniele Roberto Giacobbe, Silvia Corcione, Michele Bartoletti, Jannik Stemler, Livio Pagano, Oliver A. Cornely, Jon Salmanton-García

Risultato della ricerca: Contributo in rivistaArticolo in rivista


Background: We assessed the laboratory diagnosis and treatment of invasive fungal disease (IFD) in Italy to detect limitations and potential for improvement. Methods: The survey was available online at management capacity/, and collected variables such as (a) institution profile, (b) perceptions of IFD in the respective institution, (c) microscopy, (d) culture and fungal identification, (e) serology, (f) antigen detection, (g) molecular tests, (h) susceptibility testing and (i) therapeutic drug monitoring (TDM). Results: The laboratory capacity study received responses from 49 Italian centres, with an equitable geographical distribution of locations. The majority of respondents (n = 36, 73%) assessed the occurrence of IFD as moderate-high, with Aspergillus spp. being the pathogen of highest concern, followed by Candida spp. and Mucorales. Although 46 (94%) of the institutions had access to microscopy, less than half of them performed direct microscopy on clinical specimens always when IFD was suspected. Cultures were available in all assessed laboratories, while molecular testing and serology were available in 41 (83%), each. Antigen detection tests and antifungal drugs were also generally accessible (> 90%) among the participating institutions. Nevertheless, access to TDM was limited (n = 31, 63%), with a significant association established between therapeutic drug monitoring availability and higher gross domestic product per capita. Conclusions: Apart from TDM, Italy is adequately prepared for the diagnosis and treatment of IFD, with no significant disparities depending on gross domestic product. Future efforts may need to focus on enhancing the availability and application of direct microscopic methods, as well as TDM, to promote optimal treatment and better patient outcomes.
Lingua originaleEnglish
pagine (da-a)197-208
Numero di pagine12
Stato di pubblicazionePubblicato - 2024


  • Antifungals
  • Antigen
  • Culture, serology
  • Diagnostic capacity, microscopy
  • Italy
  • Molecular test
  • Mycology
  • Therapeutic drug monitoring


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