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中国医院真菌诊断能力的差异:一项强调分子检测差距和与GDP相关不平等的全国性调查

Disparities in Fungal Diagnostic Capacity Across Chinese Hospitals: A Nationwide Survey Highlighting Gaps in Molecular Testing and GDP-Linked Inequalities.

作者信息

Tian Ruiqing, Bai Qianqian, Xu Tianyi, Richardson Malcolm, de Hoog Sybren, Yu Jin, Zhou Shaoqin, Li Ruoyu, Song Yinggai

机构信息

Department of Dermatology and Venerology, Peking University First Hospital, No. 8 Xishiku Street, Xi Cheng District, Beijing, China.

Research Center for Medical Mycology, Peking University, Beijing, China.

出版信息

Mycopathologia. 2025 Aug 24;190(5):77. doi: 10.1007/s11046-025-00982-2.

Abstract

BACKGROUND

With the increasing incidence of fungal infection in China, the need for rapid and accurate diagnosis of mycosis is crucial. Therefore, it is necessary to understand the diagnosis capacity for mycosis.

METHODS

A cross-sectional online survey was conducted across all 31 provincial-level regions in China from August 2023 to April 2024. The survey comprised 77 questions evaluating fungal diagnostic methods, including culture, microscopy, molecular tests, and related biomarkers. Data from 1,009 valid responses were stratified by hospital tier (tertiary A vs. non-tertiary A) and regional GDP levels to analyze on-site testing capacity and outsourcing patterns.

RESULTS

Among the 1,009 respondents, 78.5% were from tertiary A hospitals. Mycology testing was more commonly performed in tertiary hospitals compared to other. Traditional mycological diagnostic methods showed no significant differences in application across regions, regardless of economic development. However, disparities emerged in novel tests, particularly molecular diagnostics: hospitals in low-GDP regions were more likely to outsource molecular testing or lack in-house capacity.

CONCLUSIONS

China's fungal diagnostic capacity remains concentrated in tertiary A hospitals and high-GDP regions. Future efforts should prioritize expanding molecular testing access and optimizing resource distribution across all healthcare settings.

摘要

背景

随着中国真菌感染发病率的上升,快速准确诊断真菌病的需求至关重要。因此,有必要了解真菌病的诊断能力。

方法

于2023年8月至2024年4月在中国31个省级行政区开展了一项横断面在线调查。该调查包括77个评估真菌诊断方法的问题,涵盖培养、显微镜检查、分子检测及相关生物标志物。来自1009份有效回复的数据按医院级别(三级甲等医院与非三级甲等医院)和地区GDP水平进行分层,以分析现场检测能力和外包模式。

结果

在1009名受访者中,78.5%来自三级甲等医院。与其他医院相比,真菌学检测在三级医院中更常开展。无论经济发展情况如何,传统真菌学诊断方法在各地区的应用无显著差异。然而,新型检测方法,尤其是分子诊断方面存在差异:低GDP地区的医院更有可能外包分子检测或缺乏内部检测能力。

结论

中国的真菌诊断能力仍集中在三级甲等医院和高GDP地区。未来应优先努力扩大分子检测的可及性,并优化所有医疗机构的资源分配。

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