Management of Invasive Fungal Infections in Adult Patients with Hematological Malignancies in Greece during the Financial Crisis: Challenges and Recommendations.
Nikolaos V Sipsas, Maria N Pagoni, Diamantis P Kofteridis, Joseph Meletiadis, Georgia Vrioni, Maria Papaioannou, Anastasia Antoniadou, George Petrikkos, George Samonis
Author Information
Nikolaos V Sipsas: Infectious Diseases Unit, Laiko General Hospital and Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece. nsipsas@med.uoa.gr. ORCID
Maria N Pagoni: Haematology-Lymphomas Department and BMT Unit, Evangelismos Hospital, 10676 Athens, Greece. marianpagoni@yahoo.com.
Diamantis P Kofteridis: Department of Internal Medicine, Infectious Diseases Unit, University of Crete Medical School, Heraklion, 71500 Crete, Greece. kofterid@med.uoc.gr.
Joseph Meletiadis: Clinical Microbiology Laboratory, Attikon University Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece. jmeletiadis@med.uoa.gr.
Georgia Vrioni: Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece. gvrioni@med.uoa.gr.
Maria Papaioannou: Hematology Unit, First Department of Internal Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, 54621 Thessaloniki, Greece. marygpap@gmail.com.
Anastasia Antoniadou: 4th Department of Internal Medicine, University General Hospital Attikon, National and Kapodistrian University of Athens, 12462 Athens, Greece. ananto@med.uoa.gr.
George Petrikkos: 4th Department of Internal Medicine, University General Hospital Attikon, National and Kapodistrian University of Athens, 12462 Athens, Greece. petrikos@hol.gr.
George Samonis: Department of Internal Medicine, Infectious Diseases Unit, University of Crete Medical School, Heraklion, 71500 Crete, Greece. samonis@med.uoc.gr.
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.
