Methods: Here, we conducted an online survey aimed to assess availability, routine diagnostic procedures and access to therapy. Contacts were made through LIFE initiative (Leading International Fungal Education), SBI (Brazilian Society of Infectious Diseases), SBAC (Brazilian Society of Clinical Analysis) and SBM (Brazilian Society of Microbiology) during the first 2018 trimester.
Results: We got 128 responses, each one from a single health care institution. Countries included Brazil (96), Mexico (9), Colombia (5), Uruguay (3), Guatemala (3), Argentina (2), Chile (2), Paraguay (2), Venezuela (2), Barbados (1), Ecuador (1), Honduras (1) and Peru (1). Most frequent institution profiles were public (38%), private (14%) and university hospitals (22%). Number of hospital beds varied between 12-3000 (median 200 beds). ICU beds ranged 3-500 (15 beds). Most institutions provided care for hematology (63%) and HIV (31%) patients. Yeast identification was performed by biochemical tests (76%), automated methods (65%), and MALDI-TOF (15%). Twelve percent of responders had access to DNA sequencing. Almost a half (39%) of institutions did not undertake antifungal susceptibility tests, 47% did it only for yeasts, 2% molds. Fifteen (12%) institutions performed antifungal susceptibility tests routinely for all fungal isolates. Automated methods were the most frequently used antifungal susceptibility methodology (38%). Eighty-two (64%) institutions had no access to therapeutic drug monitoring (TDM). Cryptococccal antigen testing was available for 75% of responders.
Conclusion: This survey was the largest and most updated snapshot of the clinical mycology scenario in Latin America and Caribbean. Efforts should be made to improve diagnostic capabilities and equalize regional disparities.