State of Medical Mycology at German Academic Medical Centres: A Survey of the German-Speaking Mycological Society (DMYKG) and the Paul-Ehrlich-Society for Chemotherapy (PEG).

BACKGROUND: Little is known about the infrastructure to translate advances in the management of patients at risk to develop invasive opportunistic fungal diseases. To assess the current state of Medical Mycology support in Germany, we conducted a survey among all 36 academic medical centres. METHODS: The survey consisted of a 3-pages questionnaire sent out in the first half of 2019. Information included details of infrastructure, education and teaching; consultation services and interdisciplinary conferences; research activities and participation in network groups; radiology, microbiology and pharmacology support; publication activity; and European Confederation for Medical Mycology (ECMM) Excellence Center designation, if assigned. RESULTS: Information was returned from 24 centres (67%). Thirteen institutions (54%) reported an independent infectious disease, and two a separate Medical Mycology department (8%); a Medical Mycology working group was reported for nine institutions (38%). An infectious disease consultation service was existent in 16 institutions (67%) and a multidisciplinary conference in 13 (54%). Fifteen institutions reported a separate study office with activities in infectious disease studies (63%). Laboratory capability for fungal identification and susceptibility testing was confirmed by all 24 institutions; testing of galactomannan by 23 (96%), cryptococcal antigen by 21 (88%), ß-D-Glucan by 9 (38%), and panfungal and Pneumocystis PCR by 21 and 22 (88% and 92%), respectively. Therapeutic drug monitoring of voriconazole was reported to be available in 15 (63%) institutions with a turnaround of ≤24 h during weekdays in 10 (42%). Two of the 24 University hospitals (8%) reported ECMM Diamond Excellence Status. CONCLUSIONS: The results of this survey document the continuing need to improve the availability of specialised Medical Mycology support in German academic medical centres.

The Canadian Fungal Research Network: current challenges and future opportunities.

Fungi critically impact the health and function of global ecosystems and economies. In Canada, fungal researchers often work within silos defined by subdiscipline and institutional type, complicating the collaborations necessary to understand the impacts fungi have on the environment, economy, and plant and animal health. Here, we announce the establishment of the Canadian Fungal Research Network (CanFunNet, https://fungalresearch.ca), whose mission is to strengthen and promote fungal research in Canada by facilitating dialogue among scientists. We summarize the challenges and opportunities for Canadian fungal research that were discussed at CanFunNet's inaugural meeting in 2019, and identify 4 priorities for our community: (i) increasing collaboration among scientists, (ii) studying diversity in the context of ecological disturbance, (iii) preserving culture collections in the absence of sustained funding, and (iv) leveraging diverse expertise to attract trainees. We have gathered additional information to support our recommendations, including a survey identifying underrepresentation of fungal-related courses at Canadian universities, a list of Canadian fungaria and culture collections, and a case study of a human fungal pathogen outbreak. We anticipate that these discussions will help prioritize fungal research in Canada, and we welcome all researchers to join this nationwide effort to enhance knowledge dissemination and funding advocacy.

Clinicians' challenges in managing patients with invasive fungal diseases in seven Asian countries: An Asia Fungal Working Group (AFWG) Survey.

BACKGROUND: Invasive fungal diseases (IFD) are a serious threat, but physicians in Asia lack access to many advanced diagnostics in mycology. It is likely that they face other impediments in the management of IFD. A gap analysis was performed to understand the challenges Asian physicians faced in medical mycology. METHODS: The Asia Fungal Working Group (AFWG) conducted a web-based survey on management practices for IFD among clinicians in China, India, Indonesia, Philippines, Singapore, Taiwan and Thailand. FINDINGS: Among 292 respondents, 51.7% were infectious disease (ID) specialists. Only 37% of respondents had received formal training in medical mycology. They handled only around 2-4 proven cases of each fungal infection monthly, with invasive candidiasis the most common. For laboratory support, the majority had access to direct microscopy (96%) and histopathology (87%), but galactomannan and azole levels were available to 60% and 25% of respondents, respectively. The majority (84%) used clinical parameters for treatment response monitoring, and 77% followed the Infectious Diseases Society of America guidelines. The majority (84%) did not use the services of an ID physician. Where febrile neutropenia was concerned, 74% of respondents used the empirical approach. Only 30% had an antifungal stewardship program in their hospital. Eighty percent could not use preferred antifungals because of cost. INTERPRETATION: The survey identified inadequacies in medical mycology training, non-culture diagnostics, access to antifungal drugs, and local guidelines as the major gaps in the management of IFDs in Asian countries. These gaps are targets for improvement.

The Curious Case of "Case Report" of Infections Caused by Human and Animal Fungal Pathogens: An Educational Tool, an Online Archive, or a Format in Need of Retooling.

Case reports describe the unusual occurrence and complications of diseases, diagnostic challenges, and notable therapeutic successes. Some journals have discontinued the case reports, while new case report journals have appeared in recent years. During the eightieth anniversary of Mycopathologia, it is fitting to examine the relevance of the case report since the journal continues to traverse the boundaries of basic and clinical sciences. A random sample of recent case reports and other articles were selected from Mycopathologia. Springer Nature individual article download statistics, and Google Scholar and Scopus citations numbers were compared to assess the reader access and bibliometric impact of case reports. Our analysis indicated that the case report format continues to be a vital element of publication in a cross-disciplinary journal such as Mycopathologia. Medical and veterinary case reports covering fungal pathogens are widely read as evident from their download numbers. The download numbers have a positive correlation with the completeness of the report, the topics and geographic origin of reports have a neutral influence, and the recency leads to lower downloads. There is no discernible trend between the download numbers and the citations of case reports as measured by Google Scholar and Scopus. A specially designed checklist for Mycopathologia case reports and new format MycopathologiaIMAGES are being introduced to improve the quality and relevance of case reports further.

Especialistas graduados en el Instituto Nacional de Higiene "Rafael Rangel", tutoría y trabajos especiales de grado en el área de micología médica durante el periodo 2007 ­ 2014 / Specialists graduated in the National Institute of Hygiene "Rafael Rangel", tutorship and degree theses in the area of medical mycology, period 2007 ­ 2014

El Instituto Nacional de Higiene "Rafael Rangel" (INHRR) inició las actividades académicas de la Especialización en Micología Médica en septiembre de 2007. En los primeros ocho años de actividad, el Instituto ha concluido cuatro cohortes de especialistas. El objetivo del presente trabajo fue presentar una descripción de los especialistas graduados en el INHRR, los tutores y los trabajos especiales de grado (TEG) en el área de micología médica durante el periodo 2007 ­ 2014. Para ello, se realizó una investigación documental y de tipo descriptiva, revisando los expedientes resguardados en los archivos de la Coordinación de Postgrado de la Gerencia de Docencia e Investigación del INHRR. Con este programa de postgrado, el Instituto graduó a 23 especialistas en micología médica con un elevado índice académico (17,5 puntos). La mayoría de los egresados de la especialización fueron mujeres bioanalistas egresadas de la Universidad Central de Venezuela, quienes laboraban en entes públicos al momento de iniciar el programa. El 61% de los TEG defendidos se realizaron dentro de dos de las líneas de investigación que lleva adelante el Departamento de Micología Médica del INHRR, a saber: las micosis en pacientes inmunocompetentes e inmunocomprometidos utilizando el diagnóstico convencional y la resistencia antifúngica de hongos levaduriformes. Ocho profesionales fueron los encargados de dirigir los TEG, bajo la figura de tutor: dos se destacaron por haber dirigido el 52% de los TEG y tres por ser egresados de la especialización. Solo el 38% de los tutores fueron externos al Instituto

The National Institute of Hygiene "Rafael Rangel" (INHRR) began the academic activities of the Medical Mycology Specialization in September 2007. In the first eight years, the Institute has graduated four cohorts of specialists. The aim of this work was to present a description of the specialists graduated in the INHRR, their advisors and degree theses (DT) in the field of medical mycology, during the period 2007 ­ 2014. Documentary and descriptive research were carried out; reviewing the records kept in the Postgraduate Coordination archives of the Management for Teaching and Research, INHRR. With this program, the Institute graduated 23 specialists in medical mycology with a high academic score (17.5 points). Most of the specialists were bioanalyst women graduated from the Central University of Venezuela, who worked in public entities at the beginning of the program. Sixty-one percent of the DT was conducted in two of the research lines carried out by the Department of Medical Mycology, INHRR, namely: mycoses in immunocompetent and immunocompromised patients using conventional diagnosis and antifungal resistance of yeast infections. Eight professionals supervised the DT, under the figure of tutor. Two tutors excelled for supervising 52% of the DT and three tutors for being graduates of the specialization. Only 38% of the tutors were external to the Institute

Mycological Education for Dermatologists.

Mycotic infections remain important in dermatological clinics. Therefore the mycological training curriculum needs to be reorganized starting from the beginning of dermatological education, including routine examination procedures, such as potassium hydroxide examination, culture of pathogenic fungi, histopathology, treatment guidelines, and the recent advances in medical mycology.Several mycological institutes will be selected and announced in the journal to provide support for mycological examinations and to publish important cases treated in clinics. The roles of the Japanese Society for Medical Mycology in these activities are discussed.

Manual de diagnóstico de las micosis sistemáticas / Manual of diagnosis of systematic fungal diseases

manual es brindar un material de apoyo para el diagnóstico micológico a los laboratorios del Ministerio de Salud Pública y Bienestar Social y servir de material complementario para los cursos de capacitación realizados por la sección Micología del Departamento de Bacteriología y Micología del Laboratorio Central de Salud Pública, y de esta manera fortalecer la capacidad diagnóstica de las micosis sistémicas, especialmente la Paracoccidioidomicosis, la principal micosis sistémica del Paraguay

The Mobile Team of Parasitology-Mycology, a medical entity for educational purposes to serve sick patients.

The Mobile Team of Parasitology-Mycology is a movable entity of the Parasitology-Mycology laboratory of Tours University Hospital, France. In contrast to the usual prerogatives of biomedical laboratories, the Mobile Team of Parasitology-Mycology is requested to intervene directly at bedside in various clinical departments, or even outside the hospital facility. Although its actions are of course primarily devoted to specialized diagnostic and therapeutic purposes, the Mobile Team also plays an important educational role in the medical training of undergraduate or graduate students.

[Mycology in the 21st century: crisis and revitalization]. / La mycologie au début du 21ème siècle: crise et renouveau.

Although they are key players in the biosphere and have important roles in human industry, agriculture and health, fungi are largely understudied and, more disturbingly, often underrepresented in biology classes at all levels. Nevertheless, it is most likely that mycology will soon undergo a renewal of interest. Firstly, because fungi are becoming more prominent in human concerns, as their impact on human, animal and ecosystem health are increasing, animal and plant biologists become more aware of their importance. Moreover, mycologists have organized to make their discipline more visible and to enable large scale scientific projects, such as the global analyses of fungal phylogeny and of their genome structure, function and evolution. This, combined with the next generation of sequencing technologies, now permits an in depth and global understanding on how fungi are organized and how they function. It also enables the development of strategies that will help to fight fungi when they negatively interfere with human concerns, as in human mycosis, or to use them in industries such as in renewable energy usage.

[Strategy for educating senior dermatological residents in mycology].

To improve the ability of dermatologists to diagnose cutaneous mycoses, we have proposed a list of the minimum mycological knowledge and skills required by senior residents of dermatology. The list includes ability to select the most appropriate sampling method, knowledge of the basic method of potassium hydroxide (KOH) examination and skill in performing fungal cultures and identifying the most prevalent fungal species isolated from skin lesions. It is not possible for the Japanese Society of Medical Mycology to train every senior resident directly, and it is difficult for them to acquire sufficient expertise independently. Consequently, training and advice given by instructors in residents' home institutes is essential. A project of an advanced course for instructors, who are in charge of educating senior residents in their own institute, may be possible. Therefore, we have proposed here a list for instructors of the knowledge and skills required to educate senior residents. Employing this list should realize improved skill in dermatologists.

[Thirty years of the "Asociación Española de Micología"]. / La Asociación Española de Micología cumple 30 años.

Since the foundation of the "Asociación Española de Micología" thirty years ago, we have consolidated the Spanish mycological community and also witnessed remarkable changes, not only in the Spanish society but in the scientific community as a whole. As it usually happens to human beings, during this time the "Asociación Española de Micología" has matured transforming itself into a solid scientific society. However, the "Asociación Española de Micología" will have to continue its transformation to adapt to new changes. This article shows the most relevant aspects in the history of the "Asociación Española de Micología" as well as new challenges that the society might face in the future.

Enseñar y evaluar la micología: reflexiones y propuesta de innovación educativa / Teaching and to evaluate the Mycology: reflections and proposal of educative innovation

Se plantea una estrategia de enseñanza que implica el desarrollo en secuencia de un plan de actividades complementarias entre si y se describe una propuesta de evaluación de las competencias de los estudiantes de Micología de la carrera de Bioquímica, basada en el estudio de casos, observación directa del desempeño estudiantil, evaluación de la ejecución yt del resultado, lo que acerca al alumno a la práctica del ejercicio profesional en la que la teoría se relaciona directamente con los problemas prácticos, sin que se separen "conocer" y "hacer".

[The current status of clinical laboratories on mycological examination].

A questionnaire survey to determine the current status of clinical laboratories on mycological examination was performed in May 2002, and the results compared with data obtained in December 1994. One hundred and sixty seven answers were received in this survey. The results indicated that the average number of medical technologists in a microbiological laboratory was one for every 168 hospital beds, and the number of clinical specimens examined daily by each technologist was 16 (bacterial) and 3.4 (mycological). The rate of laboratories prepared a specialized technologist to handle mycological examinations was 10% in both surveys, and laboratories which had a system for mycological examination order were 23.4% (this survey) and 14.1% (prior). The problems in routine mycological examination were: identification of non-sporulating filamentous fungi, 69.9%; identification of the fungi not previously encountered, 67.5%; and judgement of pathogenicity of the isolates, 66.9%. Sixty four percent of technologists desired a lecture on the subject of dermatophytes, techniques of mycological examination, dematiaceous fungi, and moniliaceous fungi other than Aspergillus. The above results indicate to establish a continuous postgraduate education system and reference center readily available to a medical technologist.

Total quality management in dermato-mycology in Germany.

Mycoses of the skin are extremely frequent. The clinical presentation often resembles the one of other frequent inflammatory skin diseases not caused by fungi. Adequate diagnostics are critical for the establishment of proper treatment. A total quality management system has been devised in Germany during the last 5 years. There are several guidelines addressing various aspects of the management of various types of disease as well as structure quality of laboratory diagnostics. Continuous medical education and so-called ring trials are major aspects of implementation.

Status of medical mycology education.

The number of immunocompromised patients and subsequent invasive fungal infections continues to rise. However, the education of future medical mycologists to engage this growing problem is diminishing. While there are an increasing number of publications and grants awarded in mycology, the time and detail devoted to teaching medical mycology in United States medical schools are inadequate. Here we review the history in medical mycology education and the current educational opportunities. To accurately gauge contemporary teaching we also conducted a prospective survey of microbiology and immunology departmental chairpersons in United States medical schools to determine the amount and content of contemporary education in medical mycology.