Landscape of fungal diagnosis in Thailand: A national survey in 2024-2025

Abstract

Background: Fungal infections pose a significant global health threat, particularly in Asia, with Thailand experiencinghigh prevalence due to its tropical climate. Increased capacity for fungal diagnosis leads to the appropriate diagnosis and treatment, and most importantly, a reduction in illness and death.

Objectives: To assess and update the current status of fungal diagnosis capacity in Thailand.

Materials and methods: This study utilized an online platform to conduct a survey. The questionnaires collected the relevant information of the laboratory capacity including the capability of the on-site fungal identification, methods for fungal identification, the most commonly identified fungal pathogen and the availability of antifungal susceptibility testing (AFST).

Results: There were 206 healthcare facilities across country participated in this survey, including both government and private hospitals, as well as one reference laboratory. Nearly all high-tier hospitals utilized advanced automated systems for yeast identification; however, mold identification remained limited, primarily relying on traditional culture and microscopy methods. According to the survey results, the most commonly identified yeast was Candida albicans, while the most commonly identified mold was Aspergillus spp. Although many laboratories could identify fungal pathogens, they often struggled to specify the species, which is essential for effective treatment and managing antifungal resistance. AFST was accessible in high-tier hospitals, but low-tier hospitals did not have this capability.

Conclusion: These findings underscore the importance of enhancing the capacity for fungal diagnosis, which will help elucidate the national burden of fungal diseases and improve resource allocation in Thailand.