Unveiling the Hungarian landscape of laboratory and clinical management capacities for invasive fungal infections: navigating the frontlines against fungal menaces

Background:Antifungal diagnostic capacity has been documented in various countries, there is a lack of comprehensive research on clinical mycology diagnostics and treatment in Hungary.Methods:We conducted an online survey encompassing questions that explored various aspects of the mycology diagnostic and antifungal therapy-related information. The survey aimed to gather details about institutional profiles, perceptions of invasive fungal infections (IFIs), and access to microscopy, culture, serology, antigen detection, molecular testing, and therapeutic drug monitoring.Results:As of May 2023, a total of 17 institutions responded to the questionnaire. Seven participants categorized the institutional incidence of IFI as 'very low', four as 'low', and six as 'mild'. The majority of centers identified Candida spp. (94%) and Aspergillus spp. (82%) as the most prevalent fungal pathogens. Nearly half of the laboratories (47%) reported using matrix-assisted laser desorption/ionization-time of flight mass spectrometry for identification. All institutions had access to microscopy and culture-based diagnostic approaches. A significant number of centers had access to antigen detection (71%) and various molecular assays (59%). Regarding antifungal agents, all reporting sites used at least one triazole, with voriconazole (77%) being the most common mold-active azole. Furthermore, 71% of the centers applied at least one formulation of amphotericin B, and 65% to one echinocandin. However, only 18% of the centers used 5-flucytosine.Conclusion:Resource availability for diagnosing and treating IFI in Hungary varies across hospitals based on location. Surveys help identify gaps and limitations in this area. To address these challenges, interregional cooperation within Hungary could be a facilitating strategy. Exploring how Hungary deals with serious fungal infections: facing fungal threats head-onBackground: While various countries have looked into their ability to diagnose fungal infections, there hasn't been a comprehensive study on how Hungary deals with diagnosing and treating these infections.Methods: We did an online survey with questions about how hospitals in Hungary handle fungal infections. We wanted to know about the hospitals' characteristics, how they see these infections, and what tools they use for diagnosis and treatment.Results: As of May 2023, we got responses from 17 hospitals. Some said they hardly ever see these infections, while others said they see them a bit more. Most hospitals found Candida and Aspergillus as the most common fungal culprits. Many used a tool called MALDI-TOF MS for identification. All of them had ways to look at samples under a microscope and grow them in a dish. Many hospitals had tests to look for certain things in the blood (71%), and they also used different genetic tests (59%). When it came to medicines, they all had at least one kind of medicine called a triazole, with voriconazole being the most common one. They also had amphotericin B and echinocandins. But only a few had a medicine called 5-flucytosine.Conclusion: Hospitals in Hungary differ in how they handle fungal infections. Doing surveys like this can help find problems and limits. To fix these issues, hospitals in different parts of Hungary can work together.