617. Laboratory capacities to diagnose and treat Invasive Fungal Infections in Europe: results from an ECMM survey

Abstract

Abstract Background Invasive fungal infections (IFI) are a major threat for patients under immunosuppression or with viral respiratory infections, like influenza or coronavirus disease 2019 (COVID-19). Access to appropriate tools is vital for early diagnosis and clinical management. The European Confederation of Medical Mycology (ECMM) survey on laboratory capacities in Europe aims to decipher the current diagnostic capacity and availability of treatments for IFIs in order to guide health professionals, patients, and policymakers. Methods The ECMM IFI diagnostic capacity survey is online accessible at www.clinicalsurveys.net/uc/IFI_management_capacity/. A campaign seeking for mycologist feedback was launched. The survey was disseminated to all European mycologists affiliated with the ECMM and via social media (i.e., LinkedIn or Twitter) and email. Collected variables were a) institution profile, b) perceptions on invasive fungal disease in the respective institution, c) microscopy, d) culture and fungal identification, e) serology, f) antigen detection, g) molecular tests and h) therapeutic drug monitoring. Results 258 centers from 41 countries have participated in the survey (Figure 1). Germany (n=30), France (n=28), Italy, Spain (n=23, each) and Turkey (n=21) were the origin country of almost half of the respondents. Incidence of IFI was considered as very low or low in 46.9% of the institutions, and moderate in 38.0%. Candida spp. (95.0%) and Aspergillus spp. (89.9%) were considered the most relevant pathogens. All the institutions had access (on site or outsourced) to cultures (68.2% of which could also perform susceptibility tests in molds and yeasts, 26.4% only in yeasts, 4.7% in none and 0.8% only in molds). Regarding availability of other diagnostic tests, 84.5% could also utilize microscopy, 83.7% antigen detection tests (89.8% of which at least Aspergillus galactomannan test), 73.3% molecular tests (mainly PCR), and 62.4% to serology. At least one triazole was available for prescribing in 93.0% of the institutions, whereas at least one echinocandin in 90.3% and liposomal amphotericin B in 80.2%. Conclusion Europe is generally well prepared to diagnose and treat invasive fungal infections. However, some institutions miss access to certain diagnostic tools and antifungal drugs. Disclosures Martin Hoenigl, n/a, Astellas: Grant/Research Support|Euroimmun: Grant/Research Support|F2G: Grant/Research Support|Gilead: Grant/Research Support|Immy: Grant/Research Support|MSD: Grant/Research Support|Mundipharma: Grant/Research Support|Pfizer: Grant/Research Support|Pulmocide: Grant/Research Support|Scynexis: Grant/Research Support Oliver A. Cornely, MD PhD, DZIF: Advisor/Consultant|DZIF: Board Member|DZIF: Grant/Research Support|DZIF: Honoraria|DZIF: Stocks/Bonds