Shao Pei-Lan, Huang Li-Min, Hsueh Po-Ren
Department of Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
Int J Antimicrob Agents. 2007 Dec;30(6):487-95. doi: 10.1016/j.ijantimicag.2007.07.019. Epub 2007 Oct 24.
The frequency of invasive fungal infections (IFIs) has increased over the last decade with the rise in at-risk populations of patients. The morbidity and mortality of IFIs are high and management of these conditions is a great challenge. With the widespread adoption of antifungal prophylaxis, the epidemiology of invasive fungal pathogens has changed. Non-albicans Candida, non-fumigatus Aspergillus and moulds other than Aspergillus have become increasingly recognised causes of invasive diseases. These emerging fungi are characterised by resistance or lower susceptibility to standard antifungal agents. Invasive infections due to these previously rare fungi are therefore more difficult to treat. Recently developed antifungal agents provide the potential to improve management options and therapeutic outcomes of these infections. The availability of more potent and less toxic antifungal agents, such as second-generation triazoles and echinocandins, has led to considerable improvement in the treatment of IFIs. This article reviews the changing spectrum of invasive mycosis, the properties of recently developed antifungal agents and their role in the management of these infections.
在过去十年中，随着患者高危人群数量的增加，侵袭性真菌感染（IFI）的发生率有所上升。IFI的发病率和死亡率很高，对这些病症的管理是一项巨大挑战。随着抗真菌预防措施的广泛应用，侵袭性真菌病原体的流行病学已发生变化。非白色念珠菌、非烟曲霉以及除曲霉以外的霉菌已日益被确认为侵袭性疾病的病因。这些新兴真菌的特点是对标准抗真菌药物具有耐药性或较低的敏感性。因此，由这些先前罕见的真菌引起的侵袭性感染更难治疗。最近开发的抗真菌药物为改善这些感染的管理选择和治疗结果提供了潜力。更有效且毒性更小的抗真菌药物的出现，如第二代三唑类药物和棘白菌素类药物，已使IFI的治疗有了相当大的改善。本文综述了侵袭性真菌病不断变化的谱、最近开发的抗真菌药物的特性及其在这些感染管理中的作用。
