Pfaller M A
Department of Pathology, Oregon Health Sciences University, Portland.
Mycopathologia. 1992 Nov;120(2):65-72. doi: 10.1007/BF00578290.
The laboratory diagnosis of candidiasis continues to be problematic; however, there have been several advances in the past decade which promise to enhance our ability to identify patients at high risk for infection and/or to document invasive candidiasis in critically ill and immunocompromised patients. The introduction of commercially available biphasic blood culture medium and subsequently the lysis-centrifugation procedure has markedly improved the ability of laboratories to detect fungemia. Although serologic methods have not been very successful in diagnosing candidiasis in immunocompromised patients, several antigen detection methods are now under investigation. In addition, detection of fungal metabolites such as D-arabinitol remains promising. Finally, application of the techniques of molecular biology for typing and detection of fungal pathogens has expanded our understanding of candidal infections and may offer the most sensitive and specific means of diagnosing invasive candidiasis.
念珠菌病的实验室诊断仍然存在问题；然而，在过去十年中有几项进展有望提高我们识别感染高危患者和/或记录重症及免疫功能低下患者侵袭性念珠菌病的能力。市售双相血培养基的引入以及随后的裂解离心程序显著提高了实验室检测真菌血症的能力。尽管血清学方法在诊断免疫功能低下患者的念珠菌病方面不太成功，但目前正在研究几种抗原检测方法。此外，检测真菌代谢产物如D-阿拉伯糖醇仍然很有前景。最后，分子生物学技术在真菌病原体分型和检测中的应用扩展了我们对念珠菌感染的认识，并可能提供诊断侵袭性念珠菌病最敏感和特异的方法。
