Singh Nina, Paterson David L
University of Pittsburgh Medical Center, VA Medical Center, Infectious Disease Section, University Dr. C, Pittsburgh, PA 15240, USA. nis5+@pitt.edu
Clin Microbiol Rev. 2005 Jan;18(1):44-69. doi: 10.1128/CMR.18.1.44-69.2005.
Aspergillus infections are occurring with an increasing frequency in transplant recipients. Notable changes in the epidemiologic characteristics of this infection have occurred; these include a change in risk factors and later onset of infection. Management of invasive aspergillosis continues to be challenging, and the mortality rate, despite the use of newer antifungal agents, remains unacceptably high. Performing molecular studies to discern new targets for antifungal activity, identifying signaling pathways that may be amenable to immunologic interventions, assessing combination regimens of antifungal agents or combining antifungal agents with modulation of the host defense mechanisms, and devising diagnostic assays that can rapidly and reliably diagnose infections represent areas for future investigations that may lead to further improvement in outcomes.
曲霉感染在移植受者中出现的频率越来越高。这种感染的流行病学特征发生了显著变化;这些变化包括危险因素的改变和感染发病时间的延迟。侵袭性曲霉病的治疗仍然具有挑战性,尽管使用了更新的抗真菌药物,但其死亡率仍然高得令人无法接受。开展分子研究以识别抗真菌活性的新靶点,确定可能适合免疫干预的信号通路,评估抗真菌药物的联合治疗方案或将抗真菌药物与宿主防御机制的调节相结合,以及设计能够快速、可靠地诊断感染的诊断检测方法,这些都是未来研究的领域,可能会带来治疗效果的进一步改善。