What question did this study set out to answer?

This research aims to evaluate the laboratory capacity for diagnosing invasive fungal diseases in France.

May 16, 2026

Assessing Laboratory Capacity for Diagnosis of Fungal Infections in France: A Multicentre survey within the SINFONI Network

Key Points

This research aims to evaluate the laboratory capacity for diagnosing invasive fungal diseases in France.
Distributed a 116-item questionnaire to 58 laboratories, with an 83% response rate.
Evaluated access to diagnostic tools including molecular assays, antigen detection, and antifungal susceptibility testing.
Analyzed the use of MALDI-TOF mass spectrometry for yeast and mold identification.
Automated blood culture systems and MALDI-TOF for yeast identification were available in all surveyed labs.
Antifungal susceptibility testing was performed on-site in 98% of centres for yeasts and 77% for molds.
Biomarkers like cryptococcal antigen and Aspergillus galactomannan were widely available, while β-D-glucan testing was limited to 54% of centres.

Abstract

Abstract Invasive fungal diseases are life-threatening complications, particularly in immunocompromised patients, and require rapid and accurate diagnosis to improve clinical outcomes. Although major advances in fungal diagnostics that includes antigen detection, molecular assays, and MALDI-TOF mass spectrometry, have transformed diagnostic strategies, access to these tools remains heterogeneous. In France, national data on diagnostic capacities for invasive fungal diseases have been lacking. Using the framework of the national prospective surveillance program for invasive fungal diseases (SINFONI network), we conducted a survey to assess laboratory diagnostic practices in France. A secured 116-item questionnaire was distributed to 58 participating laboratories, of which 48 responded (83%). Automated blood culture systems and MALDI-TOF mass spectrometry for yeast identification were universally available, with 40 (83%) of the 48 participating laboratories also using MALDI-TOF for mold identification. Antifungal susceptibility testing was performed on-site in 47 (98%) centres for yeasts and in 37 (77%) for molds. Antigen-based biomarkers were widely available on-site, particularly cryptococcal antigen (n=43, 90%) and Aspergillus galactomannan (n=39, 81%), whereas β-D-glucan testing was available in only 26 (54%) of the centres. PCR-based diagnostics were implemented on-site in 43 (88%) centres, most commonly for Pneumocystis jirovecii, Aspergillus spp., and Mucorales. Systematic screening for Candidozyma auris colonization in at-risk patients was performed in 30 (63%) centres, predominantly using culture-based methods (n=24). Overall, this survey provides the first national overview of diagnostic capacities for invasive fungal diseases in France, highlighting a strong laboratory mycology infrastructure while identifying remaining gaps in access to specific biomarkers, molecular assays, and mold antifungal susceptibility testing.

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