Journal of Infection and Public Health (Aug 2024)
Mapping the path to excellence: Evaluation of the diagnostic and treatment tools for invasive fungal infections in the balkans
- Nikola Pantić,
- Aleksandra Barać,
- Vasilika Mano,
- Amela Dedeić-Ljubović,
- Ivan Malkodanski,
- Ozren Jaksić,
- Despoina Gkentzi,
- Mirjana Mitrović,
- Oxana Munteanu,
- Dijana Šišević,
- Zlate Stojanoski,
- Oana Popescu,
- Jelena Todorović,
- Oliver A. Cornely,
- Jon Salmanton-García,
- Irina-Magdalena Dumitru,
- Angeliki Stathi,
- Charalampos Mandros,
- Maja Travar,
- Danica Milobratović,
- Paraskevi Mantzana,
- Mihaela Zaharia,
- Alen Ostojić,
- Athanasios Chatzimsochou,
- Marija Tonkić,
- Suzana Otašević,
- Danijela Jovanović,
- Nikola Vukosavljević,
- Suzana Bukovski,
- Ivva Philipova,
- Vlad Jeni Laura,
- Aleksandar Savić,
- Mihaela Lupse,
- Arbune Manuela,
- Diana Dimova,
- Sabina Cviljević,
- Maria Orfanidou,
- Elisabeth Paramythiotou,
- Cristina Alexandra Cheran,
- Konstantina Gartzonika,
- Miha Skvarc,
- Lidiya Nikolcheva-Todorova,
- Tsvetelina Velikova,
- Maria Panopoulou,
- Nijaz Tihic,
- Tamara Bibić,
- Viktorija Tomic,
- Serban Elena Daniela,
- Krasimir Donchev,
- Floredana Sular,
- Ruxandra Moroti,
- Lăzureanu Elena Voichiţa,
- Toni Valković,
- Sofija Maraki
Affiliations
- Nikola Pantić
- Clinic for Hematology, University Clinical Centre of Serbia, Belgrade, Serbia; Corresponding author at: Clinic for Hematology, University Clinical Centre of Serbia, Dr Subotića 8, 11000 Belgrade, Serbia.
- Aleksandra Barać
- Faculty of Medicine, University of Belgrade, Hospital for Infectious and Tropical Diseases, Clinical Center of Serbia, Belgrade, Serbia
- Vasilika Mano
- Laboratory of Microbiology, University Medical Center of Tirana ''Mother Teresa'', Tirana, Albania
- Amela Dedeić-Ljubović
- Department of Clinical Microbiology, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
- Ivan Malkodanski
- St. Marina University Hospital, Medical University, Pleven, Bulgaria
- Ozren Jaksić
- Division of Hematology, Department of Medicine, University Hospital Dubrava, Medical School University of Zagreb, Zagreb, Croatia
- Despoina Gkentzi
- Department of Paediatrics, University of Patras, University General Hospital of Patras, Patras, Greece
- Mirjana Mitrović
- Clinic for Hematology, University Clinical Centre of Serbia, Belgrade, Serbia
- Oxana Munteanu
- Division of Pneumology and Allergology, Department of Internal Medicine, State University of Medicine and Pharmacy ''Nicolae Testemițanu'', Medpark International Hospital, Chișinău, Moldova
- Dijana Šišević
- Clinical Center of Montenegro, Podgorica, Montenegro
- Zlate Stojanoski
- University Hematology Clinic, Medical Faculty, Ss. Cyril and Methodius University, Skopje, North Macedonia
- Oana Popescu
- National Institute of Pneumology Marius Nasta, Bucharest, Romania
- Jelena Todorović
- Ljubljana University Medical Centre, Ljubljana, Slovenia
- Oliver A. Cornely
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany; Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany; Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), University of Cologne, Cologne, Germany
- Jon Salmanton-García
- Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany; Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany; Corresponding author at : Faculty of Medicine and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Herderstr. 52, 50931 Cologne, Germany.
- Irina-Magdalena Dumitru
- Angeliki Stathi
- Charalampos Mandros
- Maja Travar
- Danica Milobratović
- Paraskevi Mantzana
- Mihaela Zaharia
- Alen Ostojić
- Athanasios Chatzimsochou
- Marija Tonkić
- Suzana Otašević
- Danijela Jovanović
- Nikola Vukosavljević
- Suzana Bukovski
- Ivva Philipova
- Vlad Jeni Laura
- Aleksandar Savić
- Mihaela Lupse
- Arbune Manuela
- Diana Dimova
- Sabina Cviljević
- Maria Orfanidou
- Elisabeth Paramythiotou
- Cristina Alexandra Cheran
- Konstantina Gartzonika
- Miha Skvarc
- Lidiya Nikolcheva-Todorova
- Tsvetelina Velikova
- Maria Panopoulou
- Nijaz Tihic
- Tamara Bibić
- Viktorija Tomic
- Serban Elena Daniela
- Krasimir Donchev
- Floredana Sular
- Ruxandra Moroti
- Lăzureanu Elena Voichiţa
- Toni Valković
- Sofija Maraki
- Journal volume & issue
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Vol. 17,
no. 8
p. 102493
Abstract
Background: In the Balkans, rising concerns about invasive fungal infections over the past decade stem from various factors. Primarily, there has been a notable uptick in immunocompromised individuals, including those with chronic illnesses like immunological and hematological diseases. Thus, it is essential to assess the region's laboratory capabilities and the availability of antifungals. This evaluation is vital for gauging the preparedness to diagnose and treat fungal infections effectively, thus minimizing their public health impact. Methods: Data were collected via an online questionnaire targeting healthcare professionals specializing in relevant fields across diverse healthcare settings in Balkan countries. The survey covered various aspects, including diagnostic methods, imaging techniques, and available antifungal armamentarium. Results: Responses were obtained from 50 institutions across the Balkans. While conventional diagnostic methods like microscopy (96 %) and culture (100 %) diagnostics were widely available, access to newer diagnostic tools such as molecular assays (61 %) were limited, often relying on outsourced services. Imaging modalities like ultrasound (100 %) and CT scans (93 %) were universally accessible. A variety of antifungal drugs were available, including amphotericin B formulations (80 %), echinocandins (79 %), and triazoles (100 %). However, access to newer agents like posaconazole (62 %) and isavuconazole (45 %) was inconsistent. Therapeutic drug monitoring (53 %) services were also limited. Conclusion: The study underscores the need for equitable access to diagnostic facilities and antifungal treatments across healthcare settings in the Balkan geographic region. Improving access to molecular diagnostic tools and essential antifungal drugs, as well as implementing therapeutic drug monitoring, would optimize the management of fungal infections in the region.
