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 Table of Contents  
QUESTIONNAIRE FOR SPECIAL ARTICLE
Year : 2019  |  Volume : 21  |  Issue : 2  |  Page : 104-109

Questionnaire for special article on Mycology Diagnostics and Antifungal Stewardship


Tata Medical Center, Kolkata, West Bengal, India

Date of Submission09-Jul-2019
Date of Acceptance16-Dec-2019
Date of Web Publication17-Jan-2020

Correspondence Address:
Dr. Gaurav Goel
Tata Medical Center, Kolkata, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jacm.jacm_36_19

Rights and Permissions

How to cite this article:
Goel G. Questionnaire for special article on Mycology Diagnostics and Antifungal Stewardship. J Acad Clin Microbiol 2019;21:104-9

How to cite this URL:
Goel G. Questionnaire for special article on Mycology Diagnostics and Antifungal Stewardship. J Acad Clin Microbiol [serial online] 2019 [cited 2020 Jul 15];21:104-9. Available from: http://www.jacmjournal.org/text.asp?2019/21/2/104/276124




  Introduction Top


Fungal infections have emerged as a major cause of morbidity, mortality, health-care cost and health-care resource utilisation across the world as well as in India. Antifungal resistance is on the rise. The recent pandemic of Candida auris is a reminder to the danger posed by fungal infections. The infections caused by fungi are dangerous not only to immunocompromised patients but also with patients with comorbidities such as diabetes. Fungi are also emerging as an important cause of health-care-associated infections and device-related infections as well as a post-infectious complication of viral infections such as influenza.


  Invitation Top


Dear colleagues,

We would be very grateful for your participation in this survey which will help all of us to understand better the problem of fungal infections, the state of mycology diagnostics and the practice of antifungal stewardship. Please note that your institute data would not be disclosed with any identifier and we would be looking at the cumulative data for the analysis. If you wish to participate in this survey by completing this questionnaire, we would like to invite you to be an author of the special article on this topic which we plan to publish by June 2020.

We look forward to your participation. Your participation is very important as it will provide valuable data for clinical microbiologists, infection control specialists, and policy-makers to take decisions with better evidence.

Thank you and best regards.

Editorial Board of Journal of the Academy of Clinical Microbiologists

Please mail the completed questionnaire to: anju130289@gmail.com

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.


  Questionnaire Top


Name of the Hospital:

City: State:

Name of the person filling up the questionnaire:

Designation

Contact number (mobile):

E-mail:

Section A: About the lab

  1. Is you laboratory:


    1. Hospital based
    2. Stand alone


  2. Is the laboratory part of:


    1. Public sector
    2. Private sector


  3. Do you have a mycology facility in your microbiology lab?


    1. Yes
    2. No


  4. If you have mycology laboratory facilities please mention the type of infrastructure you have for mycology:


    1. Light microscope: Yes/No
    2. Fluorescence microscope: Yes/No
    3. Blood culture system for Fungi: Yes/No
    4. Dedicated 37°C incubator for mycology: Yes/No
    5. Dedicated 22–25°C incubator for mycology: Yes/No
    6. Biosafety cabinet: Yes/No
    7. Biosafety Level 3 Laboratory: Yes/No
    8. Dedicated reporting time for mycology: Yes/No
    9. Dedicated laboratory staff for mycology: Yes/No
    10. Dedicated faculty/consultant for mycology: Yes/No


  5. What is your method for the identification of fungi:


    1. Morphology: Yes/No
    2. Biochemical reactions: Yes/No
    3. Automated identification system: e.g., (VITEK/Phoenix etc.): Yes/No
    4. Matrix-assisted laser desorption/ionization-time-of-flight (MALDI-TOF): Yes/No
    5. DNA sequencing: Yes/No


  6. Do you do any of the following tests in mycology:


    1. Galactomannan antigen ELISA: Yes/No
    2. Mannan antigen ELISA: Yes/No
    3. Anti-mannan antibody ELISA: Yes/No
    4. Beta-D-glucan antigen ELISA: Yes/No
    5. Cryptococcus antigen ELISA: Yes/No
    6. Aspergillusserology (IgE, IgG, etc.): Yes/No


  7. What is your method for performing anti-fungal susceptibility tests?


    1. Disc diffusion: Yes/No
    2. E-test: Yes/No
    3. Automated system (e.g., VITEK, Phoenix, etc.): Yes/No
    4. Broth dilution for yeasts: Yes/No
    5. Broth dilution test for filamentous fungi: Yes/No
    6. Molecular method (polymerase chain reaction [PCR]/sequencing based): Yes/No


  8. What is your method of identifying C. auris?


    1. Automated system VITEK, Phoenix, etc.)
    2. In-house biochemical tests with other phenotypic tests
    3. MALDI-TOF
    4. DNA sequencing
    5. Others: Please specify….


  9. Does you laboratory have the facility of detecting Pneumocystis jirovecii?


    1. Yes/No
    2. If yes, method? PCR/immunofluorescence/special stains (please encircle your method)


  10. If you detect C. auris what is your method of performing anti-fungal susceptibility test?


    1. Broth dilution
    2. E-test
    3. Automated system (please specify…….)
    4. Other: Please specify:…….


  11. Does your mycology laboratory participate in:


    1. Mycology external quality assurance services: Yes/No
    2. Mycology inter-laboratory comparison: Yes/No


  12. Are any of the mycology tests National Accreditation Board for Testing and Calibration Laboratories accredited?


    1. Yes/No
    2. If yes, please name the tests


  13. Do you perform antifungal susceptibility testing:


    1. Only when requested: Yes/No
    2. Only when the isolate is thought to be clinical significant: Yes/No
    3. In all isolates of yeasts: Yes/No
    4. In all isolates of filamentous fungi: Yes/No
    5. No AFST facilities are present: Yes/No


  14. Do you outsource certain mycology tests?


    1. Yes/No
    2. If yes, please name few:


Section B: About the epidemiology

  1. What are the common Fungi detected in your mycology lab: (Please name top 5)


    1. ……………
    2. …………….
    3. …………….
    4. ………………
    5. ……………….


  2. What type of patients is there in your hospital?


    1. HIV/AIDS in significant numbers: Yes/No
    2. Solid-organ transplant patients: Yes/No
    3. Bone marrow transplant patients: Yes/No
    4. Cancer patients receiving chemotherapy: Yes/No
    5. Neonatal intensive care unit: Yes/No
    6. Adult intensive care unit: Yes/No
    7. Cancer surgery patients: Yes/No
    8. General hospital: Yes/No
    9. Dermatology patients in significant numbers: Yes/No
    10. Patients with sexually transmitted infections: Yes/No


  3. What is the most common type of yeast detected in your laboratory?


    1. Candida albicans: Yes/No
    2. Non-albicans Candida: Yes/No
    3. Cryptococcus: Yes/No
    4. Others: Yes/No; please specify………….


  4. Among the filamentous fungi, what is the most common type detected in your laboratory? (please also rank them as one being the most common type and 4 the rarest)


    1. Aspergillus sp.:
    2. Mucor (zygomycetes):
    3. Dermatophytes:
    4. Others:


  5. Among the Aspergillus sp., what is the most common species detected in your laboratory? (please also rank them as one being the most common type and 5 the rarest)


    1. Aspergillus fumigatus
    2. Aspergillus flavus
    3. Aspergillus niger
    4. Aspergillus terreus
    5. Others


  6. Among the zygomycete fungi what is the most common type detected in your laboratory? (please also rank them as one being the most common type and 6 the rarest)


    1. Mucor
    2. Rhizopus
    3. Absidia
    4. Rhizomucor
    5. Cunninghamella
    6. Other; please specify….


  7. Among the dermatophyte group what is the common type detected in your laboratory? (please also rank them as one being the most common type and 3 the rarest)


    1. Microsporum spp.
    2. Trichophyton spp.
    3. Epidermophyton spp.


  8. Among the Candida spp., what is the most common species detected in your laboartory? (please also rank them as one being the most common type and 7 the rarest)


    1. C. albicans
    2. Candida tropicalis
    3. Candida parapsilosis
    4. Candida glabrata
    5. Candida krusei
    6. C. auris
    7. Others; please specify:


  9. Among the Cryptococcus spp., please mention the most common type detected in your laboratory (please also rank them as one being the most common type and 3 the rarest)


    1. Cryptococcus neoformans
    2. Cryptococcus gattii
    3. Others


  10. Please name some unusual or rare fungal infections detected by your laboratory in the last year:


    1. …….
    2. ……….
    3. ……….


  11. Have you encountered any outbreak of fungal infections in your hospital within the last 12 months?


    1. Yes/No
    2. If yes, please specify the name of the fungus


Section C: Antifungal stewardship

  1. What are the preferred antifungal in your institute for the treatment of candida bloodstream infection? (Please rank: One being the most preferred and 5 being the least preferred)


    1. …….
    2. …….
    3. …….
    4. …….
    5. ….…


  2. What are the preferred antifungal in your institute for the treatment of invasive aspergillosis? (Please rank: One being the most preferred and 5 being the least preferred)


    1. …….
    2. …….
    3. …….
    4. …….
    5. ……


  3. What are the preferred antifungal in your institute for the treatment of mucormycosis? (Please rank: One being the most preferred and 5 being the least preferred)


    1. …….
    2. …….
    3. …….
    4. …….
    5. ….…


  4. What are the preferred antifungal in your institute for the treatment of dermatophyte infection? (Please rank: One being the most preferred and 5 being the least preferred)


    1. …….
    2. …….
    3. …….
    4. …….
    5. ….…


  5. What are the preferred antifungal(s) in your institute for the treatment of cryptococcal meningitis? (Please rank: One being the most preferred and 5 being the least preferred)


    1. …….
    2. …….
    3. …….
    4. …….
    5. …….


  6. What are the preferred antifungal in your institute for the treatment of P. jirovecii infection? (Please rank: One being the most preferred and 5 being the least preferred)


    1. Cotrimoxazole IV
    2. Cotrimoxazole oral
    3. Dapsone
    4. Clindamycin
    5. Others


  7. Do you use steroids in the treatment of P. jirovecii infection?


    1. Always
    2. Only in certain conditions; please specify
    3. Never


  8. Does your hospital pharmacy have an antifungal formulary where recommended compounds and brands are only kept and not others?


    1. Yes
    2. No
    3. Not yet but trying


  9. Do you do therapeutic drug level monitoring for antifungal agents in your institute?


    1. Yes/No
    2. If yes, please mention name of antifungal and the technology used to do time-division multiplexing (e.g., high-performance liquid chromatography, bioassay, immunoassay and mass spectroscopy)


  10. Does your institute have an antifungal policy like an antibiotic policy?


    1. Yes/No
    2. Some departments have not all > please name


  11. Do you use anti-fungal agents for prophylaxis in your institute?


    1. Yes
    2. No


  12. If anti-fungal agents are used for prophylaxis please mention the anti-fungal and the disease (indications) where they are used for prophylaxis?


    1. ……….
    2. …………
    3. …………
    4. …………
    5. ………….


  13. Do you check anti-fungal dose, duration, method of administration, drug interactions and cost/affordability during ward rounds?


    1. Always for most of the above parameters
    2. Sometimes
    3. Rarely or never.







 

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