Background: Invasive fungal infections can cause morbidity and mortality, particularly among immunocompromised and critically ill patients, making them an important global public health problem. Outcomes depend on timely diagnosis, laboratory capacity, and access to effective antifungal therapy. As national data describing these resources in Chile remain limited, we aimed to characterize national gaps in mycological diagnostic and therapeutic access. Methods: We conducted a nationwide survey of physicians, pharmacists, and laboratory professionals representing Chilean hospitals. Multiple responses from the same institution were consolidated. A 15-item diagnostic and therapeutic access score was developed to assess differences between hospitals. Results: Thirty-five hospitals participated in the survey. Diagnostic infrastructure varied substantially across institutions; all hospitals reported access to direct mycological examination, among which 65.7% had access to MALDI-TOF MS and 51.4% used molecular identification methods. The access score differed significantly according to hospital size, with median scores of 53.3% (20.0–80.0), 66.7% (46.7–86.7), and 73.3% (60.0–86.7) in hospitals with 0–300, 301–499, and ≥500 beds, respectively (p = 0.003). Conclusions: This nationwide assessment identified size-dependent inequities in mycological capacity in Chile, with larger hospitals having greater diagnostic and therapeutic access. These findings support targeted national strategies to strengthen smaller institutions and ensure equitable care.

Background: Invasive fungal infections are an important global public health problem, causing morbidity and mortality, particularly among immunocompromised and critically ill patients. Outcomes depend on timely diagnosis, laboratory capacity, and access to effective antifungal therapy. However, national data describing these resources in Chile remain limited. We aimed to characterize gaps in mycological diagnostic and therapeutic access. Methods: We conducted a nationwide survey of physicians, pharmacists, and laboratory professionals representing Chilean hospitals. Multiple responses from the same institution were consolidated. A 15-item diagnostic and therapeutic access score was developed to assess differences between hospitals. Results: 35 hospitals participated. Diagnostic infrastructure varied substantially across institutions. Although all hospitals reported access to direct mycological examination, 65.7% had MALDI-TOF MS and 51.4% had molecular identification methods. The access score differed significantly according to hospital size, with median scores of 53.3% (20.0–80.0), 66.7% (46.7–86.7), and 73.3% (60.0–86.7) in hospitals with 0–300, 301–499, and ≥500 beds, respectively (p=0.003). Conclusions: This nationwide assessment identified size-dependent inequities in mycological capacity in Chile. Larger hospitals had greater diagnostic and therapeutic access, supporting targeted national strategies to strengthen smaller institutions and ensure equitable care.

Invasive Fungal Infections (IFIs) represent a significant threat to transplant recipients and patients with non-HIV-related immunosuppression, particularly in low- and middle-income countries (LMICs). While the disease burden in HIV populations is widely recognized, this group faces a critical gap in diagnosis and treatment that perpetuates a cycle of preventable deaths. Advances in medical therapies have revolutionized the management of hematologic malignancies, autoimmune diseases, and solid organ transplantation, increasing the number of severely immunocompromised individuals susceptible to opportunistic pathogens. In the US, IFI incidence rose from 30.2 to 31.8 per 100,000 between 2006 and 2015 [1]. However, epidemiological knowledge in LMICs remains limited due to scarce surveillance, high diagnostic and treatment costs, and low access to diagnostic methods, with disparities between regions and even within centers from the same countries. Current clinical guidelines must be adapted to regional resources to optimize diagnostic strategies and timely treatment. This review aims to analyze the primary gaps in LMICs to identify key intervention nodes for reducing mortality in non-HIV immunocompromised patients in our region.