Transplant and Oncology Infectious Diseases Program, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
Infect Dis Clin North Am. 2013 Jun;27(2):305-16. doi: 10.1016/j.idc.2013.02.004. Epub 2013 Apr 17.
The most important emerging and rare fungal pathogens in solid organ transplant recipients are the Zygomycetes, Scedosporium, Fusarium, and the dark molds. Factors affecting the emergence of these fungi include the combination of intensive immunosuppressive regimens with increasingly widespread use of long-term azole antifungal therapy; employment of aggressive diagnostic approaches (eg, sampling of bronchoalveolar lavage fluid); and changes in patients' interactions with the environment. This article reviews the epidemiology, microbiology, and clinical impact of emerging fungal infections in solid organ transplant recipients, and provides up-to-date recommendations on their treatment.
实体器官移植受者中最重要的新发和罕见真菌病原体是接合菌、枝孢霉属、镰孢霉属和暗色真菌。影响这些真菌出现的因素包括强化免疫抑制方案与长期唑类抗真菌治疗的广泛应用相结合;采用积极的诊断方法(例如,支气管肺泡灌洗液采样);以及患者与环境相互作用的变化。本文综述了实体器官移植受者中新发真菌感染的流行病学、微生物学和临床影响,并就其治疗提供了最新建议。