Integrated Multidisciplinary Management of Invasive Fungal Infections Dr. Murat Akova Hacettepe...
-
Upload
arlene-thompson -
Category
Documents
-
view
218 -
download
0
Transcript of Integrated Multidisciplinary Management of Invasive Fungal Infections Dr. Murat Akova Hacettepe...
![Page 1: Integrated Multidisciplinary Management of Invasive Fungal Infections Dr. Murat Akova Hacettepe University School of Medicine Section of Infcetious Diseases.](https://reader036.fdocuments.us/reader036/viewer/2022062423/5697bf811a28abf838c85417/html5/thumbnails/1.jpg)
Integrated Multidisciplinary Management of Invasive Fungal
Infections Dr. Murat Akova
Hacettepe University School of MedicineSection of Infcetious DiseasesAnkara
![Page 2: Integrated Multidisciplinary Management of Invasive Fungal Infections Dr. Murat Akova Hacettepe University School of Medicine Section of Infcetious Diseases.](https://reader036.fdocuments.us/reader036/viewer/2022062423/5697bf811a28abf838c85417/html5/thumbnails/2.jpg)
Survey for Management of IFD
• 18 questions• Published in Turkish Febrile
Neutropenia website• Sent to 36 internationally renowned
experts by e-mail• Sent to meeting participants
![Page 3: Integrated Multidisciplinary Management of Invasive Fungal Infections Dr. Murat Akova Hacettepe University School of Medicine Section of Infcetious Diseases.](https://reader036.fdocuments.us/reader036/viewer/2022062423/5697bf811a28abf838c85417/html5/thumbnails/3.jpg)
Respondants
• 36 Turkish physicians• 24 international experts• 11 meeting participants• Total 71 responses
![Page 4: Integrated Multidisciplinary Management of Invasive Fungal Infections Dr. Murat Akova Hacettepe University School of Medicine Section of Infcetious Diseases.](https://reader036.fdocuments.us/reader036/viewer/2022062423/5697bf811a28abf838c85417/html5/thumbnails/4.jpg)
Results of Survey
• Countries– Turkey (38)– Italy (6)– Greece (4)– Israel (3)– Germany (2)– Russia (2)– Romania (2)– Slovakia (2)– Spain (2) – The Netherlands (2)
• One of each– Austria– Belgium– Croatia– Czech Republic– France– Hungary– India– Lebanon– Poland– Switzerland
71 respondents from 20 countries
![Page 5: Integrated Multidisciplinary Management of Invasive Fungal Infections Dr. Murat Akova Hacettepe University School of Medicine Section of Infcetious Diseases.](https://reader036.fdocuments.us/reader036/viewer/2022062423/5697bf811a28abf838c85417/html5/thumbnails/5.jpg)
Type of SpecialityN=71
ID (40)Hematology (28)Microbiology (4)
59%
36%
5%
![Page 6: Integrated Multidisciplinary Management of Invasive Fungal Infections Dr. Murat Akova Hacettepe University School of Medicine Section of Infcetious Diseases.](https://reader036.fdocuments.us/reader036/viewer/2022062423/5697bf811a28abf838c85417/html5/thumbnails/6.jpg)
Size of Hospital (no. of beds)
68%
<100 101-250 251-500 >500
10%
7%
15%
N=71
![Page 7: Integrated Multidisciplinary Management of Invasive Fungal Infections Dr. Murat Akova Hacettepe University School of Medicine Section of Infcetious Diseases.](https://reader036.fdocuments.us/reader036/viewer/2022062423/5697bf811a28abf838c85417/html5/thumbnails/7.jpg)
How Many Patients Treated for an IFD per Month?
31%
27%
40%
2%
<56-1011-15>20
N=70
![Page 8: Integrated Multidisciplinary Management of Invasive Fungal Infections Dr. Murat Akova Hacettepe University School of Medicine Section of Infcetious Diseases.](https://reader036.fdocuments.us/reader036/viewer/2022062423/5697bf811a28abf838c85417/html5/thumbnails/8.jpg)
How Many Patients Treated for a Probable or Proven IFD per Month?
18%
51%
23%
8%
<12-56-10>10
N=39
![Page 9: Integrated Multidisciplinary Management of Invasive Fungal Infections Dr. Murat Akova Hacettepe University School of Medicine Section of Infcetious Diseases.](https://reader036.fdocuments.us/reader036/viewer/2022062423/5697bf811a28abf838c85417/html5/thumbnails/9.jpg)
Integrated Care Pathway for Managing IFD
79%
18%
3%
YesNoDon't know
N=39
![Page 10: Integrated Multidisciplinary Management of Invasive Fungal Infections Dr. Murat Akova Hacettepe University School of Medicine Section of Infcetious Diseases.](https://reader036.fdocuments.us/reader036/viewer/2022062423/5697bf811a28abf838c85417/html5/thumbnails/10.jpg)
Who Decides for Antifungal Therapy
60%
40%
Primary physicianID after consultation
N=71
![Page 11: Integrated Multidisciplinary Management of Invasive Fungal Infections Dr. Murat Akova Hacettepe University School of Medicine Section of Infcetious Diseases.](https://reader036.fdocuments.us/reader036/viewer/2022062423/5697bf811a28abf838c85417/html5/thumbnails/11.jpg)
When ID is consulted?
56%34%
10%
AlwaysWhen patient deterio-ratesNever
N=70
![Page 12: Integrated Multidisciplinary Management of Invasive Fungal Infections Dr. Murat Akova Hacettepe University School of Medicine Section of Infcetious Diseases.](https://reader036.fdocuments.us/reader036/viewer/2022062423/5697bf811a28abf838c85417/html5/thumbnails/12.jpg)
Other Team Members
Radiol
ogist
Chest
phy
sician
Clin. P
harm
acist
Surge
on/in
tens
ivist
0
20
40
60
80
100
%
![Page 13: Integrated Multidisciplinary Management of Invasive Fungal Infections Dr. Murat Akova Hacettepe University School of Medicine Section of Infcetious Diseases.](https://reader036.fdocuments.us/reader036/viewer/2022062423/5697bf811a28abf838c85417/html5/thumbnails/13.jpg)
Bedside Discussions with Team Members
15%
17%
47%
21%
DailyWeeklyWhen requiredNo
N=71
![Page 14: Integrated Multidisciplinary Management of Invasive Fungal Infections Dr. Murat Akova Hacettepe University School of Medicine Section of Infcetious Diseases.](https://reader036.fdocuments.us/reader036/viewer/2022062423/5697bf811a28abf838c85417/html5/thumbnails/14.jpg)
Tests Available-I
Serum GLM BAL GLM Serum BGC Fungal PCR Crypto Ag in CSF
0
20
40
60
80
100
%
![Page 15: Integrated Multidisciplinary Management of Invasive Fungal Infections Dr. Murat Akova Hacettepe University School of Medicine Section of Infcetious Diseases.](https://reader036.fdocuments.us/reader036/viewer/2022062423/5697bf811a28abf838c85417/html5/thumbnails/15.jpg)
Tests Available-II
HRCT Low-dose CT
MRI PET scan BAL TB biopsy0
20
40
60
80
100
%
![Page 16: Integrated Multidisciplinary Management of Invasive Fungal Infections Dr. Murat Akova Hacettepe University School of Medicine Section of Infcetious Diseases.](https://reader036.fdocuments.us/reader036/viewer/2022062423/5697bf811a28abf838c85417/html5/thumbnails/16.jpg)
Tests Available-III
Gra
m st
ain
PCP det
ectio
n
Funga
l cult
ure
AFST
Tissue
biop
sy
Patho
logist
Single
room
0
20
40
60
80
100
%
![Page 17: Integrated Multidisciplinary Management of Invasive Fungal Infections Dr. Murat Akova Hacettepe University School of Medicine Section of Infcetious Diseases.](https://reader036.fdocuments.us/reader036/viewer/2022062423/5697bf811a28abf838c85417/html5/thumbnails/17.jpg)
Where is the Biopsied Tissue Sent?
1%7%
91%
MicrobiologyPathologyBoth
N=70
![Page 18: Integrated Multidisciplinary Management of Invasive Fungal Infections Dr. Murat Akova Hacettepe University School of Medicine Section of Infcetious Diseases.](https://reader036.fdocuments.us/reader036/viewer/2022062423/5697bf811a28abf838c85417/html5/thumbnails/18.jpg)
How Often is an Autopsy Done?
4%4% 10
%
81%
50-80%30-50%10-30%<10%
N=68
![Page 19: Integrated Multidisciplinary Management of Invasive Fungal Infections Dr. Murat Akova Hacettepe University School of Medicine Section of Infcetious Diseases.](https://reader036.fdocuments.us/reader036/viewer/2022062423/5697bf811a28abf838c85417/html5/thumbnails/19.jpg)
When is Serum GM Reported?
13%
40%28%
18%
The same day2 days3 days>3 days
N=71
![Page 20: Integrated Multidisciplinary Management of Invasive Fungal Infections Dr. Murat Akova Hacettepe University School of Medicine Section of Infcetious Diseases.](https://reader036.fdocuments.us/reader036/viewer/2022062423/5697bf811a28abf838c85417/html5/thumbnails/20.jpg)
When is CT or MRI Reported?
57%25%
13%
6%
The same day2 days3 days>3 days
N=71
![Page 21: Integrated Multidisciplinary Management of Invasive Fungal Infections Dr. Murat Akova Hacettepe University School of Medicine Section of Infcetious Diseases.](https://reader036.fdocuments.us/reader036/viewer/2022062423/5697bf811a28abf838c85417/html5/thumbnails/21.jpg)
When are Pathology Results Reported?
3%13%
13%
7%65%
The same day2 days3 days4 days>4 days
N=71
![Page 22: Integrated Multidisciplinary Management of Invasive Fungal Infections Dr. Murat Akova Hacettepe University School of Medicine Section of Infcetious Diseases.](https://reader036.fdocuments.us/reader036/viewer/2022062423/5697bf811a28abf838c85417/html5/thumbnails/22.jpg)
Prioritised Reporting in Microbiology, Radiology and Pathology
68%
30%
3%
YesNoDon't know
N=71
![Page 23: Integrated Multidisciplinary Management of Invasive Fungal Infections Dr. Murat Akova Hacettepe University School of Medicine Section of Infcetious Diseases.](https://reader036.fdocuments.us/reader036/viewer/2022062423/5697bf811a28abf838c85417/html5/thumbnails/23.jpg)
Thoracic Surgical Team Available
67%
29%
4%
YesNoDon't know
N=71
![Page 24: Integrated Multidisciplinary Management of Invasive Fungal Infections Dr. Murat Akova Hacettepe University School of Medicine Section of Infcetious Diseases.](https://reader036.fdocuments.us/reader036/viewer/2022062423/5697bf811a28abf838c85417/html5/thumbnails/24.jpg)
Summary
• Management of IFD requires a teamwork which is an essential part of an “Integrated Care Pathway”
• Many centres in Europe and its neighbours have the baseline setup and a protocol
• Further collaboration at the team- and administrative-level is desired