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Fungi under fire: diagnostic capacities and antifungal availability in Peruvian healthcare facilities

Summary

This study examined how well Peruvian hospitals can diagnose and treat serious fungal infections across the country. Researchers surveyed 54 healthcare centers and found that while basic fungal tests are available everywhere, advanced diagnostic tools and certain antifungal medications are mostly limited to the capital city of Lima. The research identifies major gaps in care that need to be addressed to help more patients survive these serious infections.

Background

Invasive fungal infections (IFI) are a significant global health issue affecting an estimated 7 million people annually with around 3 million deaths. In Peru, IFIs are estimated to affect about 2% of the population, with underdiagnosis due to limited sensitivity of diagnostic tests. The country faces additional challenges from endemic mycoses due to its geographical climate heterogeneity.

Objective

This study evaluates the diagnostic capabilities of mycology laboratories and the availability of antifungal treatments in Peruvian healthcare facilities to identify gaps and improve IFI management across different regions and healthcare settings.

Results

All centers reported low to moderate IFI incidence, with Candida spp. identified as the most concerning pathogen (93%), followed by Aspergillus spp. and Cryptococcus spp. (57% each). Microscopy was universally used (100%), while culture-based diagnosis was available in 90% of centers. Advanced diagnostics varied significantly, with better availability in the capital (91%) compared to regions (64%). Triazoles were the most accessible antifungals (96%), while echinocandins and therapeutic drug monitoring were severely limited (37% and 2%, respectively).

Conclusion

The study highlights significant disparities in the availability of advanced diagnostics and antifungals in Peru, particularly between the capital and other regions. Despite universal use of microscopy, access to species identification, antibody and antigen detection tests is limited outside Lima. Ensuring equitable access to resources and implementing therapeutic drug monitoring are crucial for improving IFI management in Peru.
  • Published in:Microbiology Spectrum,
  • Study Type:Cross-sectional observational study,
  • Source: PMID: 40539798, DOI: 10.1128/spectrum.02020-24
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