Maschmeyer Georg
Department of Haematology and Oncology, Klinikum Ernst von Bergmann, Potsdam 14467, Germany.
J Antimicrob Chemother. 2009 May;63 Suppl 1:i27-30. doi: 10.1093/jac/dkp084.
Isolation of patients at risk of invasive mould infection might be suitable for the reduction of invasive aspergillosis or zygomycosis, if combined with high-efficiency particulate air filtration. Prophylactic wearing of filtering masks of N95 or FFP2 standards has not yet been demonstrated to be efficacious in reducing invasive mould infections outside of scenarios with excessive contamination of room air by fungal spore-loaded dust. The oral broad-spectrum antifungal azoles posaconazole and voriconazole offer protection against invasive Aspergillus infections in severely neutropenic leukaemia patients and allogeneic haematopoietic stem cell transplant recipients; however, their routine use might result not only in considerable side effects, but also in the spread of multi-azole-resistant Aspergillus species, so that careful selection of suitable high-risk patient populations is mandatory.
如果与高效空气过滤器相结合，隔离有侵袭性霉菌感染风险的患者可能有助于减少侵袭性曲霉病或接合菌病。尚未证明在N95或FFP2标准的过滤口罩预防方面，在房间空气被含真菌孢子灰尘过度污染的情况之外，对减少侵袭性霉菌感染是有效的。口服广谱抗真菌唑类药物泊沙康唑和伏立康唑可预防严重中性粒细胞减少的白血病患者和异基因造血干细胞移植受者发生侵袭性曲霉感染；然而，常规使用它们不仅可能导致相当多的副作用，还可能导致多重唑类耐药曲霉菌种的传播，因此必须谨慎选择合适的高风险患者群体。
