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[抗真菌药敏试验的最新进展]

[An update on antifungal susceptibility testing].

作者信息

Tapia P Cecilia V

机构信息

Programa de Microbiología y Micología, ICBM, Facultad de Medicina, Universidad de ChileSantiago, Chile.

出版信息

Rev Chilena Infectol. 2009 Apr;26(2):144-50. Epub 2009 Jun 16.

Abstract

Due to increasing of invasive fungal infections and emergeney of antifungal drugs resistant fungi, standardized methods of antifungal susceptibility testing (AST) have been developed. The Clinical Laboratory Standards Instutute (CLSI) and the European for Committee Antimicrobial Susceptibility Testing (EUCAST) have guidelines for susceptibility of yeasts by broth microdilution (M27-A2 and E. Dis. 7.1 documents, respectively). Both are equivalent, although they present methodological and interpretative breakpoints differences. In addition, the CLSI have the M38-A (for filamentous fungi) and M44-A (disk diffusion) documents, whereas EUCAST is developing a document for Aspergillus spp. Furthermore, commercial methods are available that display good correlation with the methods of reference such as E-test, Sensititre and Vitek2. The interpretation of the results must be careful because the determination of the minimum inhibitory concentration (CIM) is difficult for fungi, there are host factors involved and not always there is a correlation between MIC and clinical outcome. Due to these methods are laborious and require trained personnel, to ask for AST to a reference laboratory is recommendable.

摘要

由于侵袭性真菌感染的增加以及抗真菌药物耐药真菌的出现,已开发出标准化的抗真菌药敏试验(AST)方法。临床实验室标准协会(CLSI)和欧洲抗菌药物敏感性试验委员会(EUCAST)分别有通过肉汤微量稀释法检测酵母菌药敏性的指南(分别为M27 - A2和E. Dis. 7.1文件)。两者等效,尽管它们在方法和解释性断点上存在差异。此外,CLSI有M38 - A(针对丝状真菌)和M44 - A(纸片扩散法)文件,而EUCAST正在制定针对曲霉属的文件。此外,还有一些商业方法,它们与参考方法如E-test、Sensititre和Vitek2显示出良好的相关性。结果的解释必须谨慎,因为真菌的最低抑菌浓度(MIC)测定困难,存在宿主因素影响,而且MIC与临床结果之间并非总是相关。由于这些方法费力且需要训练有素的人员,因此建议将AST送检至参考实验室。

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