Universität zu Köln

Ceballos-Garzon, Andres, Escandon, Patricia, Micelly, Jeisson, Cornely, Oliver A. ORCID: 0000-0001-9599-3137, Berrio, Indira and Salmanton-García, Jon ORCID: 0000-0002-6766-8297 (2026). Diagnostic and therapeutic capacity for fungal infections in Colombia: An ESCMID-EFISG nationwide multicenter assessment of mycological healthcare. International Journal of Infectious Diseases, 162. pp. 1-11. Elsevier. ISSN 12019712

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Abstract

[Artikel-Nr.: 108182] Objectives: This study aims to evaluate nationwide diagnostic and treatment capacity for IFD across Colombia’s diverse healthcare system. Methods: Between March and September 2024, a cross-sectional survey assessed institutional profiles, diagnostic access (microscopy, culture, antigen, polymerase chain reaction [PCR] testing, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry [MALDI-TOF MS]), antifungal availability, and therapeutic drug monitoring (TDM) practices. Responses were collected from 133 institutions (113 hospitals, 20 research centers) across 26/33 departments. Results: Among 179 complete responses (94 microbiologists, 85 physicians) Candida spp. (39%), Cryptococcus spp. (20%), Aspergillus spp. (18%), and Histoplasma spp. (14%), were the pathogens considered to be more worrisome. Conventional diagnostics showed broad availability (microscopy: 94%, culture: 74%), while advanced tools were limited (e.g., MALDI-TOF MS: 12%). Antigen testing access varied by pathogen (Cryptococcus spp.: 54%, Aspergillus spp.: 52%, Histoplasma spp.: 44%), with metropolitan-rural disparities (P≤0.001). Antifungal susceptibility testing was available only in 56% of the surveyed institutions. Antifungal access revealed inequities: liposomal amphotericin B (68%), echinocandins (76%), and triazoles (97%) mainly accessible in metropolitan centers. HSCT/solid organ transplant (SOT) recipients had superior access to antifungals. TDM access was limited (voriconazole/itraconazole: 32%). Conclusion: Conventional mycological methods remain the cornerstone of fungal diagnosis in Colombia. Significant disparities in IFD management capacity persist, with metropolitan centers and transplant recipients disproportionately benefiting from advanced resources. Although Colombia has established clinical guidelines incorporating World Health Organization (WHO)-recommended diagnostics and treatments, urgent nationwide implementation efforts are required to translate these recommendations into routine clinical practice and address persistent geographic and socioeconomic inequities in patient care.

Item Type:	Article
Creators:	Creators Email ORCID ORCID Put Code Ceballos-Garzon, Andres UNSPECIFIED UNSPECIFIED UNSPECIFIED Escandon, Patricia UNSPECIFIED UNSPECIFIED UNSPECIFIED Micelly, Jeisson UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, Oliver A. UNSPECIFIED https://orcid.org/0000-0001-9599-3137 UNSPECIFIED Berrio, Indira UNSPECIFIED UNSPECIFIED UNSPECIFIED Salmanton-García, Jon UNSPECIFIED https://orcid.org/0000-0002-6766-8297 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-812714
Identification Number:	10.1016/j.ijid.2025.108182
Journal or Publication Title:	International Journal of Infectious Diseases
Volume:	162
Page Range:	pp. 1-11
Number of Pages:	11
Date:	January 2026
Publisher:	Elsevier
ISSN:	12019712
Language:	English
Faculty:	Faculty of Medicine
Divisions:	CECAD - Cluster of Excellence Cellular Stress Responses in Aging-Associated Diseases Faculty of Medicine > Innere Medizin > Klinik I für Innere Medizin - Hämatologie und Onkologie Faculty of Medicine > Weitere > Centrum für integrierte Onkologie (CIO) Faculty of Medicine > Weitere > Zentrum für Klinische Studien
Subjects:	Medical sciences Medicine
Uncontrolled Keywords:	Keywords Language Colombia ; Fungal infections ; Diagnostics ; Healthcare access English
['eprint_fieldname_oa_funders' not defined]:	Publikationsfonds UzK
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/81271