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J. Fungi 2018, 4(3), 94; https://doi.org/10.3390/jof4030094

Management of Invasive Fungal Infections in Adult Patients with Hematological Malignancies in Greece during the Financial Crisis: Challenges and Recommendations

1
Infectious Diseases Unit, Laiko General Hospital and Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
2
Haematology-Lymphomas Department and BMT Unit, Evangelismos Hospital, 10676 Athens, Greece
3
Department of Internal Medicine, Infectious Diseases Unit, University of Crete Medical School, Heraklion, 71500 Crete, Greece
4
Clinical Microbiology Laboratory, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece
5
Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
6
Hematology Unit, First Department of Internal Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, 54621 Thessaloniki, Greece
7
4th Department of Internal Medicine, University General Hospital Attikon, National and Kapodistrian University of Athens, 12462 Athens, Greece
*
Author to whom correspondence should be addressed.
Received: 17 July 2018 / Revised: 4 August 2018 / Accepted: 8 August 2018 / Published: 9 August 2018
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Abstract

There are concerns that the financial crisis in Greece negatively affected the management of invasive fungal infections (IFIs) among patients with hematological malignancies (HM). A working group (WG) was formed to explore the situation and make recommendations. A questionnaire was created and distributed to physicians caring for patients with HM, to gather information in a standardized manner on prescribing physicians, patient characteristics, availability of diagnostics, antifungal treatment practices and the conditions and particularities of Greek hospitals. A total of 141 physicians from 36 hematology units and laboratories located in 26 Greek hospitals participated. Regarding hospitalization conditions, only 56% reported that their patients were treated in isolated single or double bed rooms, 22% reported availability of HEPA filters, 47% reported construction works in progress, and an alarming 18% reported the presence of birds on open windows. Regarding diagnosis, only 31% reported availability of biomarkers for diagnosis of IFIs, 76% reported that CT scans were performed in a timely fashion, 42% reported prompt availability of broncho-alveolar lavage, and only 6% availability of therapeutic drug monitoring. Of concern, 26% of the responders reported non-availability of some antifungals. In conclusion, significant challenges exist for the optimal management of IFIs in patients with HM in Greece. View Full-Text
Keywords: invasive fungal infections; hematological malignancy; financial crisis; Greece invasive fungal infections; hematological malignancy; financial crisis; Greece
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Sipsas, N.V.; Pagoni, M.N.; Kofteridis, D.P.; Meletiadis, J.; Vrioni, G.; Papaioannou, M.; Antoniadou, A.; Petrikkos, G.; Samonis, G. Management of Invasive Fungal Infections in Adult Patients with Hematological Malignancies in Greece during the Financial Crisis: Challenges and Recommendations. J. Fungi 2018, 4, 94.

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