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[系统性念珠菌病的生物学诊断:困难与未来展望]

[Biological diagnosis of systemic candidiasis: difficulties and future prospects].

作者信息

Anane S, Khalfallah F

机构信息

Département de parasitologie, faculté de médecine de Tunis, 15, rue Djebel-Lakhdar, 1007 La-Rabta, Tunisie.

出版信息

Pathol Biol (Paris). 2007 Jun;55(5):262-72. doi: 10.1016/j.patbio.2006.03.003. Epub 2006 May 12.

Abstract

The diagnosis of systemic Candidiasis is difficult to establish and biologic diagnosis raises problems. Blood culture which is the gold standard for the diagnosis of systemic Candidiasis lacks sensitivity and usually takes several days to become positive. Early diagnostic approach is imperative to avoid delays in the initiation for treatment. Therefore, nonculture methods like test for Candida antigen detection, metabolite detection or Candida DNA detection by PCR are being developed for the laboratory diagnosis. Candida derived metabolites and antigens detection lacks sensitivity. A new strategy consisting of the combined detection of mannanemia and an antibody response was developed. The combined detection has a high specificity and sensitivity in the diagnosis of invasive candidiasis. The results of tests for the detection of yeast DNA by PCR obtained recently are promising in terms of sensitivity, specificity and identification of species of Candida.

摘要

系统性念珠菌病的诊断很难确立,生物学诊断也存在问题。作为系统性念珠菌病诊断金标准的血培养缺乏敏感性,通常需要数天才能呈阳性。早期诊断方法对于避免治疗延误至关重要。因此,正在开发非培养方法,如念珠菌抗原检测、代谢物检测或通过聚合酶链反应检测念珠菌DNA,用于实验室诊断。念珠菌衍生代谢物和抗原检测缺乏敏感性。一种由联合检测甘露聚糖血症和抗体反应组成的新策略被开发出来。联合检测在侵袭性念珠菌病的诊断中具有高特异性和敏感性。最近通过聚合酶链反应检测酵母DNA的试验结果在敏感性、特异性和念珠菌菌种鉴定方面很有前景。

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