体外抗真菌药敏试验:在临床实践中有什么作用?
In Vitro Susceptibility Testing in Fungi: What is its Role in Clinical Practice?
机构信息
Division of Hygiene and Medical Microbiology, Innsbruck Medical University, Fritz Pregl Strasse 3, 6020, Innsbruck, Austria,
出版信息
Curr Infect Dis Rep. 2010 Nov;12(6):401-8. doi: 10.1007/s11908-010-0134-z.
An increasing number of patients are undergoing transplantation procedures or receiving aggressive immunosuppression and chemotherapy. The growing population of immunocompromised hosts has led to a rise in the prevalence of invasive fungal infections due to yeasts and molds. The introduction of new antifungal agents and recent reports of resistance emerging during treatment of fungal infections have highlighted the need for in vitro susceptibility testing. Various testing procedures have been proposed, including macrodilution and microdilution, agar diffusion, disk diffusion, and Etest (AB Biodisk, Solna, Sweden). Establishing clinical correlation with antifungal susceptibility testing, however, is a huge challenge because susceptibility techniques do not take into account the dynamic and complex biology of fungi exposed to an antifungal in vivo. This paper reviews the available methods for antifungal susceptibility testing of yeasts and filamentous fungi and the data regarding the clinical implications of in vitro testing.
越来越多的患者正在接受移植手术或接受强化免疫抑制和化疗。由于酵母菌和霉菌,免疫功能低下宿主的数量不断增加,导致侵袭性真菌感染的患病率上升。新型抗真菌药物的出现以及在真菌感染治疗过程中出现的耐药性的最新报告,突出了体外药敏测试的必要性。已经提出了各种测试程序,包括大稀释度和微稀释度、琼脂扩散、圆盘扩散和 Etest(AB Biodisk,瑞典 Solna)。然而,与抗真菌药敏测试建立临床相关性是一个巨大的挑战,因为药敏技术没有考虑到真菌在体内暴露于抗真菌药物时的动态和复杂的生物学特性。本文综述了用于检测酵母菌和丝状真菌的抗真菌药敏测试的现有方法,以及体外测试的临床意义相关的数据。