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ESCMID-EFISG Survey on Diagnostic and Therapeutic Capacity for Invasive Fungal Infections in Belgium, the Netherlands, and Luxembourg: A Focus on High Azole Resistance

Summary

This survey examined how well hospitals in Belgium, the Netherlands, and Luxembourg can diagnose and treat serious fungal infections, which are particularly dangerous for people with weakened immune systems. The researchers found that while most hospitals can test fungal samples, not all have access to all necessary diagnostic tools, especially tests for detecting resistant fungi and identifying fungal co-infections. Many hospitals outsource their testing to other facilities, which can delay diagnosis and treatment, and some hospitals lack access to all recommended antifungal medications.

Background

Invasive fungal infections (IFI) are major clinical challenges with high morbidity and mortality, particularly in immunocompromised patients. The Benelux region experiences high prevalence of azole-resistant Aspergillus fumigatus isolates (7-13%), making it an important area for studying diagnostic and therapeutic capacity.

Objective

This survey evaluates the diagnostic and therapeutic capacities for invasive fungal infections across Belgium, the Netherlands, and Luxembourg, with particular focus on detection and management in areas of high azole resistance.

Results

Antifungal susceptibility testing was available in 91% of institutions. Aspergillus PCR testing was available in 63.2% of Belgian centers versus 91.7% in Netherlands. Mucorales PCR was available in only 56.3% of centers. Amphotericin B was not universally available (84.4%), and significantly more testing was outsourced in Belgium compared to Netherlands.

Conclusion

While antifungal susceptibility testing is widely available in the Benelux, implementation is not yet universal in areas with high azole resistance. Testing for coinfections remains limited, outsourcing of diagnostics impacts timely diagnosis, and reimbursement policies require revision to ensure comprehensive diagnostic availability.
  • Published in:Mycoses,
  • Study Type:Survey,
  • Source: PMID: 40650433, DOI: 10.1111/myc.70092
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