{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T20:42:47Z","timestamp":1792096967811,"version":"4.4.0"},"reference-count":59,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,7,12]],"date-time":"2025-07-12T00:00:00Z","timestamp":1752278400000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Invasive fungal infections (IFI) are a major clinical challenge, particularly in immunocompromised patients, and are associated with high morbidity and mortality. With the increasing prevalence of immunosuppressive conditions and ageing populations, the incidence of IFI is rising globally.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      This survey aims to evaluate the diagnostic and therapeutic capacities for IFI in Belgium, the Netherlands, and Luxembourg (Benelux), a region of high azole\u2010resistance among\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>Aspergillus fumigatus<\/jats:italic>\n                      <\/jats:styled-content>\n                      isolates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A survey evaluating the diagnostic and therapeutic capacity for IFI was conducted in the Benelux. Data were collected from specialists via an online case report form between March and September 2023. The survey addressed patient characteristics, access to microbiology labs, diagnostic methods (microscopy, culture, molecular diagnostics, etc.), IFI incidence, and the availability of antifungal drugs and therapeutic drug monitoring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 32 hospitals responded to the questionnaire (12 [38%] from the Netherlands, 19 [59%] from Belgium and one [3%] from Luxembourg). Antifungal susceptibility tests were available in 29 institutions (91%), constituting 84% of the centres in Belgium and 100% for the Netherlands (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.265).\n                      <jats:italic>Aspergillus<\/jats:italic>\n                      PCR testing was available in 12 centres in Belgium (63%) while in 11 centres in the Netherlands (92%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.108). Mucorales PCR testing was available in 56% of centres. Treatment with at least one amphotericin B formulation was only available in 84% of the responding centres. Therapeutic drug monitoring (TDM), although recommended, was possible for voriconazole in 26 centres (81%) while for posaconazole in 24 centres (75%). Significantly more testing (diagnostic tests and TDM) was outsourced in Belgium compared to the Netherlands (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Antifungal susceptibility testing is widely available in Belgium and the Netherlands, but implementation in areas with high azole resistance for\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>Aspergillus fumigatus<\/jats:italic>\n                      <\/jats:styled-content>\n                      is not yet universal, and techniques vary. Tests for coinfections, like Mucorales PCR, were only available in half of the centres. More testing is outsourced in Belgium, likely due to differences in reference centre organisation, country size, transport, and reimbursement. Delays in diagnosis can impact patient outcomes, so awareness of test availability and transport times is crucial.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/myc.70092","type":"journal-article","created":{"date-parts":[[2025,7,12]],"date-time":"2025-07-12T07:40:08Z","timestamp":1752306008000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["ESCMID\u2010EFISG Survey on Diagnostic and Therapeutic Capacity for Invasive Fungal Infections in Belgium, the Netherlands, and Luxembourg: A Focus on High Azole Resistance"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6337-6636","authenticated-orcid":false,"given":"Robina","family":"Aerts","sequence":"first","affiliation":[{"name":"Department of Haematology Leuven University Hospitals  Leuven Belgium"},{"name":"Department of Microbiology Immunology and Transplantation, KU Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lize","family":"Cuypers","sequence":"additional","affiliation":[{"name":"KU Leuven, Department of Microbiology, Immunology and Transplantation, Laboratory of Clinical Microbiology  Leuven Belgium"},{"name":"Department of Laboratory Medicine, National Reference Centre for Rotavirus University Hospitals of Leuven  Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eelco F. J.","family":"Meijer","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Immunology Canisius\u2010Wilhelmina Hospital (CWZ)\/Dicoon  Nijmegen the Netherlands"},{"name":"Radboudumc\u2010CWZ Center of Expertise for Mycology  Nijmegen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Kohnen","sequence":"additional","affiliation":[{"name":"National Service of Infectious Diseases, Centre Hospitalier de Luxembourg  Luxembourg Luxembourg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3253-6080","authenticated-orcid":false,"given":"Jacques F.","family":"Meis","sequence":"additional","affiliation":[{"name":"Radboudumc\u2010CWZ Center of Expertise for Mycology  Nijmegen the Netherlands"},{"name":"Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging\u2010Associated Diseases (CECAD), Faculty of Medicine and University 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