Section of Infectious Diseases, Washington Hospital Center, Washington, D.C., MedStar Research Institute, Washington, DC 20010, USA.
J Intensive Care Med. 2010 Mar-Apr;25(2):78-92. doi: 10.1177/0885066609355262. Epub 2009 Dec 1.
Invasive fungal infections are major causes of morbidity and mortality in critically ill patients. Foremost among these is invasive candidiasis. In recent years, invasive aspergillosis (IA) and zygomycosis have emerged as major problems in susceptible, critically ill patients. Risk factors for invasive fungal infections, including disrupted anatomic barriers, suppressed antifungal host responses, and exposure to potentially opportunistic fungi are common in critically ill patients. The expanded antifungal armamentarium and advent of rapid diagnostic techniques are altering the approach to invasive fungal infections in the intensive care unit (ICU). Herein, we review recent developments in the field of antifungal host defenses, the changing epidemiology of fungal infections in the ICU, the pharmacology of antifungal agents of importance to critically ill patients, and the evolving approaches to therapy in this setting.
侵袭性真菌感染是重症患者发病率和死亡率的主要原因。其中最重要的是侵袭性念珠菌病。近年来，侵袭性曲霉病（IA）和接合菌病已成为易感重症患者的主要问题。包括解剖屏障破坏、抗真菌宿主反应受抑制以及接触潜在机会性真菌在内的侵袭性真菌感染的危险因素在重症患者中很常见。抗真菌药物的不断扩充和快速诊断技术的出现正在改变重症监护病房（ICU）中侵袭性真菌感染的治疗方法。在此，我们回顾了抗真菌宿主防御领域的最新进展、ICU 中真菌感染的流行病学变化、对重症患者有重要意义的抗真菌药物的药理学以及该治疗环境中治疗方法的不断发展。
