Disparities in Fungal Diagnostic Capacity Across Chinese Hospitals: A Nationwide Survey Highlighting Gaps in...

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 diagnosis capacity for mycosis.

A cross-sectional online survey was conducted across all 31 provincial-level regions in China from August 2023 to April 2024. The survey comprised 77 questions evaluating fungal diagnostic methods, including culture, microscopy, molecular tests, and related biomarkers. Data from 1,009 valid responses were stratified by hospital tier (tertiary A vs. non-tertiary A) and regional GDP levels to analyze on-site testing capacity and outsourcing patterns.

Among the 1,009 respondents, 78.5% were from tertiary A hospitals. Mycology testing was more commonly performed in tertiary hospitals compared to other. Traditional mycological diagnostic methods showed no significant differences in application across regions, regardless of economic development. However, disparities emerged in novel tests, particularly molecular diagnostics: hospitals in low-GDP regions were more likely to outsource molecular testing or lack in-house capacity.

China's fungal diagnostic capacity remains concentrated in tertiary A hospitals and high-GDP regions. Future efforts should prioritize expanding molecular testing access and optimizing resource distribution across all healthcare settings.