Investigation of mycology laboratory diagnostic capacity for fungal infection in Chinese public hospitals

<b>Background: </b>With the increasing incidence of fungal infection in China, the need for rapid and accurate diagnosis of mycosis is crucial. Therefore, it is necessary to understand the capacity of clinical laboratories to diagnose these infections.<br/><br/><b>Methods:</b> From August 2023 to April 2024, 1009 online questionnaires were collected from 31 provincial-level administrative regions in China, with 78.5% originating from tertiary A hospitals. The questionnaires, consisting of 77 questions, were designed to evaluate the laboratory capacity of Chinese public hospitals for fungal culture, antifungal susceptibility testing, microscopy, serological detection, molecular diagnosis and fungal infection-related biomarkers.<br/><br/><b>Results:</b> A higher proportion of mycology tests were performed in tertiary care hospitals compared to others, exceeding 10%. Furthermore, the stratification of Chinese regions according to Gross Domestic Product (GDP) levels revealed no significant differences in the application of conventional mycological diagnostic methods among hospitals, regardless of economic development. However, there are significant differences between regions in terms of novel tests, including molecular tests. Specifically, the proportion of hospitals that prefer to outsource molecular testing services and cannot provide appropriate molecular testing services in-house is relatively high in regions with low GDP.<br/><br/><b>Conclusions:</b> In China, the capacity of medical institutions to diagnose systemic fungal infections is relatively high for tertiary A hospitals and regions with a high GDP. However, there is a need to improve the overall fungal detection capacity, with a particular focus on molecular diagnosis in the future. More investment and training are necessary to promote access to high-quality diagnostic services.<br/><br/>