Ruhnke M, Böhme A, Buchheidt D, Donhuijsen K, Einsele H, Enzensberger R, Glasmacher A, Gümbel H, Heussel C-P, Karthaus M, Lambrecht E, Südhoff T, Szelényi H
Dept. of Medicine, Div. Onkology/Hematology, Charité Universitätsmedizin Berlin, Campus Charité Mitte, Schumannstrasse 20-21, 10117, Berlin, Germany.
Ann Hematol. 2003 Oct;82 Suppl 2:S141-8. doi: 10.1007/s00277-003-0768-0. Epub 2003 Sep 11.
Invasive fungal infections are a primary cause of morbidity and mortality in patients with hematological malignancies. Establishing a definite diagnosis of invasive fungal infection in febrile neutropenic patients is particularly challenging and time-consuming, but a delay of antifungal treatment leads to higher mortality. This situation has lead to the strategy of initiation "empirical" antifungal therapy prior to the detection of fungi. Meanwhile, improvements in diagnostic procedures are achieved, especially with imaging techniques and non-culture based methods which include antigen-based assays, metabolite detection and molecular detection of fungal DNA from body fluid samples using conserved or specific genome sequences. The AGIHO presents recommendations for the diagnosis of invasive fungal infections with risk-adapted screening concepts for the neutropenic and febrile episodes of patients with hemato-oncological disorders.
侵袭性真菌感染是血液系统恶性肿瘤患者发病和死亡的主要原因。在发热性中性粒细胞减少患者中明确诊断侵袭性真菌感染尤其具有挑战性且耗时，但抗真菌治疗的延迟会导致更高的死亡率。这种情况促使人们采取在检测到真菌之前启动“经验性”抗真菌治疗的策略。与此同时，诊断程序也在不断改进，特别是成像技术和基于非培养的方法，后者包括基于抗原的检测、代谢物检测以及使用保守或特定基因组序列从体液样本中进行真菌DNA的分子检测。AGIHO针对血液肿瘤疾病患者的中性粒细胞减少和发热发作，提出了采用风险适应性筛查概念诊断侵袭性真菌感染的建议。
