Table 1.
Questionnaire on the diagnostic capacity for invasive fungal infections in the Greek paediatric haematology-oncology units.
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Type of hospital: General Hospital □ University Hospital □ Other □ (please specify)
Your region: Specialties served in your Unit: Oncology □ Haematology □ BMT/SCT □ Infectious diseases □ Other □ (please specify) Mean number of patients hospitalised per year: Please list the 5 most common diseases you have treated during the last 2 years: a., b., c., d., e. | |||
| yes | no | ||
| Culture based methods: | |||
| 1. | Ιs there the possibility to perform the following tests in your hospital/institution? | ||
| a. | Cultures for fungal pathogens | ||
| b. | Direct microscopy of the specimen | ||
| c. | Phenotypic identification | ||
| d. | Molecular identification | ||
| e. | MALDI-TOF | ||
| If any of the answers is no, do you refer the test to another external laboratory (reference laboratory, regional, private, abroad, other)? Please specify. |
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| 2. | In case of a positive culture, is there the possibility for identification of the specific pathogens in your institution? | ||
| a. | Candida spp. | ||
| b. | Cryptococcus spp. | ||
| c. | Other yeasts | ||
| d. | Aspergillus spp. | ||
| e. | Mucorales (Rhizopus spp., Mucor spp., etc) | ||
| f. | Fusarium spp. | ||
| g. | Acremonium /Sarocladium spp. | ||
| h. | Scedosporium spp. | ||
| i. | Other moulds | ||
| If any of the answers is no, do you refer the test to another external laboratory (reference laboratory, regional, private, abroad, other)? Please specify. |
|||
| 3. | Please specify how the identification is performed in your institution (Phenotypical, Molecular, MALDI-ToF) |
||
| a. | Candida spp. | ||
| b. | Cryptococcus spp. | ||
| c. | Other yeasts | ||
| d. | Aspergillus spp. | ||
| e. | Mucorales (Rhizopus spp., Mucor spp.,etc) | ||
| f. | Fusarium spp. | ||
| g. | Acremonium/Sarocladium spp. | ||
| h. | Scedosporium spp. | ||
| i. | Other moulds | ||
| If you refer any of the identification procedures, please specify (which one do you refer and to which type of laboratory-reference, regional, private, abroad, other) | |||
| 4. | Is there availability of antifungal susceptibility testing in your hospital/institution? | ||
| a. | AFST for yeasts | ||
| b. | AFST for moulds | ||
| If any of the answers is no, do you refer the test to another external laboratory (reference laboratory, regional, private, abroad, other)? Please specify. |
|||
| 5. | Which of the following invasive fungal infections have you been diagnosed with in the last 2 years? Please provide approximate number. | ||
| a. | Invasive candidiasis | ||
| b. | Aspergillosis | ||
| c. | Mucormycosis | ||
| d. | Fusariosis | ||
| e | Pneumocystosis | ||
| f. | Other (please specify) | ||
| Non-culture based methods: | |||
| 6. | Is there the possibility to perform the following tests in your hospital/institutional laboratory? | ||
| a. | Aspergillus galactomannan | ||
| b. | 1, 3-β-D-glucan | ||
| c. | Mannan | ||
| d. | anti-Mannan | ||
| e. | Antibodies against Aspergillus | ||
| f. | Cryptococcus antigen (agglutination) | ||
| g. | Cryptococcus antigen (lateral flow) | ||
| h. | IFA for Pneumocytis jirovecii | ||
| i. | PCR for: Aspergillus □ Candida □ Cryptococcus □ Pneumocystis jirovecii □ | ||
| If any of the answers is no, do you refer the test to another external laboratory (reference laboratory, region, private, abroad, other)? Please specify. |
|||
| 7. | Which of the following tests have you performed during the last 2 years? Please provide an approximate total number for the tests you have performed. If you referred to an external laboratory, please specify how many “in house” and how many externally. |
||
| a. | Aspergillus galactomannan | ||
| b. | 1,3-β-D-glucan | ||
| c. | Mannan | ||
| d. | anti-Mannan | ||
| e. | Antibodies against Aspergillus | ||
| f. | Cryptococcus antigen (agglutination) | ||
| g. | Cryptococcus antigen (lateral flow) | ||
| h. | IFA for Pneumocytis jirovecii | ||
| i. | PCR for: Aspergillus □ Candida □ Cryptococcus □ Pneumocystis jirovecii □ |
||
| 8. | What is the turnaround time for the aforementioned tests? | ||
| a. | Aspergillus galactomannan 0–48 h □ 48 h–1 week □>1 week □ | ||
| b. | β-D-Glucan 0–48 h □ 48 h–1 week □>1 week □ | ||
| c. | Mannan 0–48 h □ 48 h–1 week □>1 week □ | ||
| d. | anti-Mannan 0–48 h □ 48 h–1 week □>1 week □ | ||
| e. | Antibodies against Aspergillus 0–48 h □ 48 h–1 week □>1 week □ | ||
| f. | Cryptococcus antigen (agglutination) 0–48 h □ 48 h–1 week □>1 week □ | ||
| g. | Cryptococcus antigen (lateral flow) 0–48 h □ 48 h–1 week □>1 week □ | ||
| h. | Aspergillus PCR 0–48 h □ 48 h–1 week □>1 week □ | ||
| i. | IFA for Pneumocytis jirovecii 0–48 h □ 48 h–1 week □>1 week □ | ||
| j. | Candida PCR 0–48 h □ 48 h–1 week □>1 week □ | ||
| k. | Cryptococcus PCR 0–48 h □ 48 h–1 week □>1 week □ | ||
| l. | Pneumocystis PCR 0–48 h □ 48 h–1 week □>1 week □ | ||
| 9. | Is there the possibility to perform TDM for the following antifungal agents? “In house” or externally? Please specify. |
||
| a. | voriconazole | ||
| b. | posaconazole | ||
| c. | isavuconazole | ||
| d. | itraconazole | ||
| e. | 5-FC | ||
| 10. | Do you believe that TDM is useful for the treatment of your patients? Please comment. | ||
| 11. | What treatment strategy do you usually apply? | ||
| Empirical □ Pre-emptive □ Targeted □ | |||
BMT/SCT: Bone Marrow Transplant/Stem Cell Transplant, MALDI-ToF: Matrix Assisted Laser Desorption Ionization-Time of Flight, AFST: antifungal susceptibility testing, IFA: Immunofluorescence Assay, TDM: Therapeutic Drug Monitoring.