Patterson T F
University of Texas Health Science Center at San Antonio, San Antonio, TX 78229-3900, USA.
Transpl Infect Dis. 2002;4 Suppl 3:38-45. doi: 10.1034/j.1399-3062.4.s3.6.x.
Invasive fungal infections have been noted in increasing frequency in immunosuppressed patients and may be due to organisms that are less susceptible or frankly resistant to antifungal agents. Recently, standards have been established for testing both yeasts and moulds for susceptibility to antifungal agents. While these tests are increasingly available for clinical use, clinicians are faced with the challenge of whether these tests offer benefit in terms of management and when they should be obtained. In this review, the relevance of these tests is discussed, as are the clinical data, especially for yeasts, that support their use. In addition, the strategy of identifying yeasts to the species level as a means for predicting susceptibility is also discussed. While susceptibility testing of all fungal isolates is not necessary and not recommended, the judicious use of these tests and the role of the mycology laboratory in assisting in management of invasive fungal infection is also evaluated.
侵袭性真菌感染在免疫抑制患者中的发生率日益增加，这可能归因于对抗真菌药物敏感性较低或完全耐药的病原体。最近，已经制定了针对酵母和霉菌对抗真菌药物敏感性的检测标准。虽然这些检测越来越多地应用于临床，但临床医生面临着这些检测在管理方面是否有益以及何时应进行检测的挑战。在这篇综述中，将讨论这些检测的相关性，以及支持其应用的临床数据，尤其是针对酵母的临床数据。此外，还将讨论将酵母鉴定到种水平作为预测药敏性的一种方法的策略。虽然并非所有真菌分离株都需要进行药敏试验，也不建议这样做，但也会评估这些检测的合理使用以及真菌学实验室在协助管理侵袭性真菌感染中的作用。
