Publications

Invasive fungal infections (IFIs) are silent killers, frequently undiagnosed and untreated. India faces significant challenges with limited diagnostic facilities, scarce data on fungal infection, and rising antifungal resistance. The COVID-associated mucormycosis surge highlighted the urgent need for stronger diagnostic infrastructure for fungal infections. Recognizing this, the Indian Council of Medical Research (ICMR) launched a network of mycology laboratories with advanced diagnostic capabilities across India using a 10-step plan described in this paper. Laboratories were selected using a three-pronged screening approach. Eight Advanced Mycology Diagnostic and Research Centers (AMDRCs) were set up in North, West, Central, South, South-Central, East, and Northeast zones from 2020 to 2022. Each AMDRC received ongoing support in training and quality assurance. The network features a digital data system, fungal repository, and clinical registry to track IFIs in ICU patients. In 2022–2023, the network identified 16.3% of fungal cases, mainly Candida spp. (56%, n = 5764/10293) and Aspergillus spp. (28%, n = 2882/10293), with 1.5% (n = 227/14861) IFIs and seven rare diseases (Eumycetoma and Chromoblastomycosis) reported in 2023. Candida auris showed high resistance to Amphotericin-B (61.2%, n = 30/49) and Fluconazole (57.1%, n = 28/49). The ICMR-MycoNet has significantly improved access to fungal diagnostics, enabling early detection and management. Comprehensive data on infection trends and resistance patterns provide valuable insights for targeted treatments and outbreak preparedness, strengthening public health efforts.