An online survey of mycology laboratories in seven Asian countries was conducted to
assess the status, competence, and services available. Country representatives from the
Asia Fungal Working Group (AFWG) contacted as many laboratories performing mycology
diagnosis as possible in their respective countries, requesting that the laboratory
heads complete the online survey. In total, 241 laboratories responded, including 71 in
China, 104 in India, 11 in Indonesia, 26 in the Philippines, four in Singapore, 18 in Taiwan,
and seven in Thailand. Overall, 129/241 (53.5%) surveyed mycology laboratories operate
as separate designated mycology laboratories, 75/241 (31.1%) conduct regular formal
staff training, 103/241 (42.7%) are accredited, and 88/157 (56.1%) participate in external
quality assurance scheme (EQAS) programs. Microscopy and culture methods are available
in nearly all laboratories, although few perform DNA sequencing (37/219; 16.9%)
or use matrix-assisted laser desorption/ionization time-of-flight mass spectroscopy (MALDI-TOF MS) (27/219; 12.3%) for isolate identification. Antifungal susceptibility testing
is performed in 142/241 (58.9%) laboratories, mainly for yeasts. The most commonly
performed nonculture diagnostic is cryptococcal antigen testing (66 laboratories), followed
by galactomannan testing (55), polymerase chain reaction (PCR) diagnosis (37),
and beta-D-glucan testing (24). Therapeutic drug monitoring is conducted in 21 laboratories.
There is almost no access to advanced diagnostic tests, like galactomannan,
β-D-glucan, and PCR, in the surveyed laboratories in Indonesia, the Philippines, and
Thailand. These results highlight the need for development of quality laboratories, accreditation
and training of manpower in existing laboratories, and access to advanced
non–culture-based diagnostic tests to facilitate the diagnosis of fungal infections in Asia