Only about half of invasive fungal infections (IFIs) are detected before death.^1,2

KNOWING IS HALF THE BATTLE
 

Given the high morbidity and mortality of IFs, an early and accurate diagnosis is more important than ever. This will help patients get prompt and appropriate treatment and may reduce unnecessary use of antifungals - both key aspects of stewardship.^1-3

Yet, diagnosis of IFs remains challenging. Clinical manifestations and imaging features vary across infections, and for most fungal pathogens no rapid and sensitive diagnostic methods exist. Where they do, access is unevenly distributed across the globe - particularly problematic in low-resource settings, where the disease burden is highest. This can render diagnosis almost impossible, and prophylaxis and empiric treatment are relied on as the standard of care in many institutions.^3-9


KNOW THE FACTS, TIME TO ACT

Diagnostics are an essential instrument in the stewardship toolbox. They improve fungal infection management and contribute to surveillance data gathering, helping in the fight against antifungal resistance (AFR).^6,7

Establishing a diagnostic-driven approach can help improve patient outcomes and achieve stewardship goals.^10,11 For example, selecting a treatment based on evidence from diagnostic tools can lead to a more targeted and effective treatment.^12,13 This approach can lead to appropriate, targeted antifungal therapy, which is key to managing IFIs in line with the principles of antifungal stewardship (AFS), and can potentially improve AFS measures such as antifungal consumption, mortality, and length of stay.^10-13


CULTURES ARE THE CORNERSTONE

Culture from a clinical sample is the gold standard. However, this method is associated with some limitations:^9,14

• Delayed results
• Low sensitiviity for candidiasis
• Low specificity for aspergillosis and invasive mould infections
• High level of expertise required to identify less common fungi

New techniques are emerging that allow faster diagnoses. But different types of fungal

infections need their own tactics. More below.