Institute of Antibiotics, Huashan Hospital, Fudan University & Key Laboratory of Clinical Pharmacology of Antibiotics, National Health Commission, Shanghai, China.
Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Beijing, China.
Mycoses. 2023 Aug;66(8):723-731. doi: 10.1111/myc.13590. Epub 2023 Apr 14.
Invasive fungal disease (IFD) is associated with high morbidity and mortality. Data are lacking regarding physicians' perspectives on the diagnosis and management of IFD in China.
To evaluate physicians' perspectives on the diagnosis and management of IFD.
Based on current guidelines, a questionnaire was designed and administered to 294 physicians working in haematology departments, intensive care units, respiratory departments and infectious diseases departments in 18 hospitals in China.
The total score and subsection scores for invasive candidiasis, invasive aspergillosis (IA), cryptococcosis and invasive mucormycosis (IM) were 72.0 ± 12.2 (maximum = 100), 11.1 ± 2.7 (maximum = 19), 43.0 ± 7.8 (maximum = 57), 8.1 ± 2.0 (maximum = 11) and 9.8 ± 2.3 (maximum = 13), respectively. Although the perspectives of the Chinese physicians were in good overall agreement with guideline recommendations, some knowledge gaps were identified. Specific areas in which the physicians' perspectives and guideline recommendations differed included use of the β-D-glucan test to facilitate the diagnosis of IFD, relative utility of the serum galactomannan test and bronchoalveolar lavage fluid galactomannan test in patients with agranulocytosis, use of imaging in the diagnosis of mucormycosis, risk factors for mucormycosis, indications for initiating antifungal therapy in patients with haematological malignancies, when to start empirical therapy in mechanically ventilated patients, first-line drugs for mucormycosis and treatment courses for IA and IM.
This study highlights the main areas that could be targeted by training programs to improve the knowledge of physicians treating patients with IFD in China.
侵袭性真菌病（IFD）与高发病率和死亡率相关。关于中国医生对 IFD 的诊断和管理的看法，目前缺乏相关数据。
评估医生对 IFD 的诊断和管理的看法。
根据当前的指南，设计了一份问卷，并在中国 18 家医院的血液科、重症监护病房、呼吸科和感染科的 294 名医生中进行了问卷调查。
侵袭性念珠菌病、侵袭性曲霉病（IA）、隐球菌病和侵袭性毛霉病（IM）的总分和分项得分分别为 72.0±12.2（满分 100）、11.1±2.7（满分 19）、43.0±7.8（满分 57）、8.1±2.0（满分 11）和 9.8±2.3（满分 13）。尽管中国医生的观点总体上与指南建议一致，但仍存在一些知识差距。医生的观点和指南建议存在差异的具体领域包括使用 β-D-葡聚糖检测来辅助 IFD 的诊断、血清半乳甘露聚糖检测和支气管肺泡灌洗液半乳甘露聚糖检测在粒细胞减少症患者中的相对效用、影像学在毛霉病诊断中的应用、毛霉病的危险因素、血液恶性肿瘤患者开始抗真菌治疗的指征、机械通气患者开始经验性治疗的时机、毛霉病的一线药物以及 IA 和 IM 的治疗疗程。
本研究强调了培训计划可以针对的主要领域，以提高中国治疗 IFD 患者的医生的知识水平。
