Access to Fungal Diagnostics in India: Findings of a Nationwide Survey
Parikshit Shirish Prayag, Sampada Ajeet Patwardhan, Mousami Kadam, Amrita P. PrayagAbstract
Background:
Invasive fungal infections (IFIs) are associated with substantial morbidity and mortality and represent a major healthcare challenge in India. Timely diagnosis is critical for optimal management, but the availability of advanced fungal diagnostics across the country remains uncertain. This nationwide survey assessed the current status of fungal diagnostic facilities in India and identified existing gaps.
Methods:
A structured questionnaire evaluating laboratory infrastructure, diagnostic capabilities, availability of antifungal susceptibility testing (AFST), fungal biomarkers, molecular diagnostics, and therapeutic drug monitoring (TDM) was distributed electronically to microbiologists and infectious disease physicians across India.
Results:
Representatives from 111 of 120 contacted centers responded. While routine fungal cultures were widely available, advanced diagnostic capabilities remained limited. Fewer than 60% of centers had a dedicated mycology laboratory. MALDI-TOF mass spectrometry was used in 18.4% and 19.0% of laboratories for identification of yeasts and molds, respectively, while only seven centers performed internal transcribed spacer sequencing. Mold AFST was available in only 14 laboratories. Access to specialized staining techniques, molecular assays for
Conclusions:
Despite measurable progress, access to comprehensive fungal diagnostics in India remains limited. Strengthening laboratory infrastructure, expanding expertise, and improving access to advanced diagnostic technologies are essential to optimize the diagnosis and management of IFIs.