Physicians' knowledge of invasive fungal disease in China

Author:

Chen Yijian1,Huang Xiaojun2,Qiu Haibo3,Cheng Linling4,Yu Yunsong5,Ma Xiaochun6,Feng Sizhou7,Li Qi8,Wu Depei9,Huang Wenxiang10,Chen Dechang11,Lv Xiaoju12,Hu Jianda13,Wang Jingbo14,Li Jiabin15,Yang Wenjie16,Zhan Qingyuan17,Sun Bing18,Wang Minggui1ORCID

Affiliation:

1. Institute of Antibiotics, Huashan Hospital Fudan University & Key Laboratory of Clinical Pharmacology of Antibiotics, National Health Commission Shanghai China

2. Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation Peking University People's Hospital Beijing China

3. Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine Southeast University Nanjing China

4. Department of Respiratory The First Affiliated Hospital of Guangzhou Medical University Guangzhou China

5. Department of Infectious Diseases, Sir Run Run Shaw Hospital Zhejiang University School of Medicine Hangzhou China

6. Department of Critical Care Medicine The First Affiliated Hospital of China Medical University Shenyang China

7. Department of Hematology, Institute of Hematology & Blood Diseases Hospital Chinese Academy of Medical Sciences & Peking Union Medical College Tianjin China

8. Department of Respiratory The Second Affiliated Hospital of Military Medical University Chongqing China

9. Department of Hematology The First Affiliated Hospital of Soochow University Suzhou China

10. Department of Infectious Disease The First Affiliated Hospital of Chongqing Medical University Chongqing China

11. Department of Critical Care Medicine, Ruijin Hospital Shanghai Jiao Tong University School of Medicine Shanghai China

12. Center of Infectious Disease, West China Hospital Sichuan University Chengdu China

13. Department of Hematology Union Hospital of Fujian Medical University Fujian China

14. Department of Hematology Aerospace Central Hospital Beijing China

15. Department of Infectious Disease The First Affiliated Hospital of Anhui Medical University Anhui China

16. Department of Infectious Diseases Tianjin First Center Hospital Tianjin China

17. Department of Respiratory, Intensive Care Unit Sino‐Japanese Friendship Hospital Beijing China

18. Intensive Care Unit Beijing Chaoyang Hospital of Capital Medical University Beijing China

Abstract

AbstractBackgroundInvasive 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.ObjectivesTo evaluate physicians' perspectives on the diagnosis and management of IFD.MethodsBased 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.ResultsThe 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.ConclusionThis study highlights the main areas that could be targeted by training programs to improve the knowledge of physicians treating patients with IFD in China.

Publisher

Wiley

Subject

Infectious Diseases,Dermatology,General Medicine

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