EFISG survey of current practices in clinical mycology laboratory services in Europe

Abstract number: p737

Bille  J., Atherton  G., Denning  D.W., Lortholary  O., Lass-Flörl  C., Arendrup  M.C., Cuenca  M., Roilides  E., Tod  M., Bretagne  S., Voss   A., Gaustad  P., Sambatakou  H., Eggimann  P., Garbino  J., Akova  M., Ullmann  A., Hebart  H., Muñoz  P., Mueller  F.M., for EFISG  

Objectives: 

Mycology laboratory services are essential to the diagnosis of mycoses. New methods (antigen detection, molecular detection or identification, antifungal susceptibility testing [AFST]) are available but it is not known to what extent they are used.

Methods: 

A questionnaire was sent to the clinical microbiologists members of ESCMID.

Results: 

171 questionnaires were returned (64% from University affiliated hospitals) with a mycology lab for 96% of them, separated from the bacteriology lab in 38%. The following tests are offered: direct examination (KOH 90%, brightener 52%, GMS 37%), culture for yeasts (99%), moulds (97%), dimorphic (65%), dermatophytes (82%), conventional identification (for yeasts 96%, moulds 85%), mostly with commercial biochemical systems (98% for yeasts). Molecular identification (sequencing) is available in 24% of labs for yeast, and in 21% for moulds. Antifungal susceptibility testing is done in 94% of the labs, mostly for clinically significant isolates only, using E-test in 42%, NCCLS-CLSI methods in 24%, disk diffusion in 10%, and Eucast methodology in 4%. Fungal serology is carried out in 72% of the labs (C. neoformans antigen 59%, Candida mannan 26%, antimannan 14%, beta-D glucan 1%, Aspergillus galactomannan in 52%). Molecular tests for fungi are carried out in 29% of the labs, for detection in 18%, for identification in 21%. Antifungal drug levels are offered in only 9% of the labs.

Conclusion: 

This survey of practices in European clinical mycology laboratories reveals the level of use of recently introduced methods (AFST, antigen or molecular detection and/or identification tests), and will be useful to EFISG and others for the planning of teaching activities or clinical studies.