Rácil Zdenek, Kocmanová Iva, Wagnerová Barbora, Winterová Jana, Mayer Jirí
Department of Internal Medicine and Hematooncology, Masaryk University School of Medicine, Brno, Czech Republic.
Klin Mikrobiol Infekc Lek. 2007 Oct;13(5):176-83.
Invasive aspergillosis is a serious and often lethal fungal infection in immunocompromised patients, with increasing incidence in recent years. The high mortality is related not only to severe immunosuppression but especially to difficulties in early diagnosis. The development of noninvasive nonculture diagnostic methods in recent years is a major advance in the early diagnosis of invasive aspergillosis, but the only method with a clear position is currently galactomannan detection by sandwich ELISA. The test has an excellent negative predictive value and is able to exclude invasive aspergillosis with high probability. In addition, its good sensitivity often allows diagnosis of the condition before it is clinically manifested. However, variations in sensitivity due to numerous factors and potential false-positive results in certain populations are the main limitations to its use. The purpose of this review is to summarize the current knowledge of the use of galactomannan in the early diagnosis of invasive aspergillosis.
侵袭性曲霉病是免疫功能低下患者中一种严重且常致命的真菌感染,近年来发病率不断上升。高死亡率不仅与严重的免疫抑制有关,尤其还与早期诊断困难有关。近年来非侵入性非培养诊断方法的发展是侵袭性曲霉病早期诊断的一项重大进展,但目前唯一具有明确地位的方法是夹心ELISA法检测半乳甘露聚糖。该检测具有出色的阴性预测价值,能够大概率排除侵袭性曲霉病。此外,其良好的敏感性常常能在疾病出现临床症状之前作出诊断。然而,由于众多因素导致的敏感性差异以及某些人群中潜在的假阳性结果是其应用的主要局限性。本综述的目的是总结目前关于半乳甘露聚糖在侵袭性曲霉病早期诊断中应用的知识。