癌症患者感染的实验室诊断：挑战与机遇
Laboratory Diagnosis of Infections in Cancer Patients: Challenges and Opportunities.
作者信息
Babady N Esther
机构信息
Clinical Microbiology Service, Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
出版信息
J Clin Microbiol. 2016 Nov;54(11):2635-2646. doi: 10.1128/JCM.00604-16. Epub 2016 Jun 8.
Abstract
Infections remain a significant cause of morbidity and mortality in cancer patients. The differential diagnosis for these patients is often wide, and the timely selection of the right clinical tests can have a significant impact on their survival. However, laboratory findings with current methodologies are often negative, challenging clinicians and laboratorians to continue the search for the responsible pathogen. Novel methodologies are providing increased sensitivity and rapid turnaround time to results but also challenging our interpretation of what is a clinically significant pathogen in cancer patients. This minireview provides an overview of the most common infections in cancer patients and discusses some of the challenges and opportunities for the clinical microbiologist supporting the care of cancer patients.
摘要
感染仍然是癌症患者发病和死亡的重要原因。这些患者的鉴别诊断范围通常很广，及时选择正确的临床检查对其生存有重大影响。然而，采用当前方法得到的实验室检查结果往往为阴性，这使得临床医生和检验人员难以找到致病病原体。新方法提高了检测的灵敏度并缩短了出结果的时间，但也让我们对癌症患者中具有临床意义的病原体的解读产生了质疑。本综述概述了癌症患者中最常见的感染，并讨论了临床微生物学家在支持癌症患者护理方面面临的一些挑战和机遇。
相似文献
1
Laboratory Diagnosis of Infections in Cancer Patients: Challenges and Opportunities.癌症患者感染的实验室诊断：挑战与机遇
J Clin Microbiol. 2016 Nov;54(11):2635-2646. doi: 10.1128/JCM.00604-16. Epub 2016 Jun 8.
2
Editorial: Pathogenesis and host response in the era of modern diagnostics: let's continue the basics.社论：现代诊断时代的发病机制与宿主反应：让我们回归基础。
Curr Opin Infect Dis. 2019 Jun;32(3):187-190. doi: 10.1097/QCO.0000000000000551.
3
Side-room tests in infectious diseases units.传染病科室的辅助检查
J Infect. 1984 Nov;9(3):227-9. doi: 10.1016/s0163-4453(84)90442-0.
4
The opening and closing of empiric windows: the impact of rapid microbiologic diagnostics.经验性治疗窗口的开启与关闭：快速微生物诊断的影响
Clin Infect Dis. 2014 Oct 15;59(8):1199-200. doi: 10.1093/cid/ciu493. Epub 2014 Jun 25.
5
Laboratory investigations and diagnosis of tropical diseases in travelers.旅行者中热带病的实验室检查与诊断。
Infect Dis Clin North Am. 2012 Sep;26(3):803-18. doi: 10.1016/j.idc.2012.06.001.
6
Molecular diagnostic tests: keeping up with mutations.分子诊断测试：紧跟突变情况。
Indian J Med Microbiol. 2011 Oct-Dec;29(4):325-6. doi: 10.4103/0255-0857.90152.
7
Laboratory microbiology to clinical microbiology: are we ready for a transition?从实验室微生物学到临床微生物学：我们准备好转型了吗？
Indian J Med Microbiol. 2009 Apr-Jun;27(2):97-9. doi: 10.4103/0255-0857.49422.
8
Comment on: "clinical microbiology: should microbiology be a clinical or a laboratory speciality?".关于《临床微生物学：微生物学应是临床专业还是实验室专业？》的评论
Indian J Pathol Microbiol. 2011 Jan-Mar;54(1):234. doi: 10.4103/0377-4929.77414.
9
Clinical microbiology: Should microbiology be a clinical or a laboratory speciality?临床微生物学：微生物学应是临床专业还是实验室专业？
Indian J Pathol Microbiol. 2010 Apr-Jun;53(2):217-21. doi: 10.4103/0377-4929.64323.
10
Routine use of point-of-care tests: usefulness and application in clinical microbiology.即时检测在临床微生物学中的应用和价值。
Clin Microbiol Infect. 2010 Aug;16(8):1054-61. doi: 10.1111/j.1469-0691.2010.03281.x.
引用本文的文献
1
Global prevalence and correlation of intestinal parasitic infections in patients with colorectal cancer: a systematic review and meta-analysis.结直肠癌患者肠道寄生虫感染的全球患病率及相关性：一项系统评价和荟萃分析。
BMC Gastroenterol. 2025 Aug 13;25(1):584. doi: 10.1186/s12876-025-04144-y.
2
Clinical Utility of Plasma Microbial Cell-Free DNA Surveillance in Neutropenic Patients with Acute Myeloid Leukemia Undergoing Outpatient Chemotherapy: A Case Series.血浆微生物游离DNA监测在接受门诊化疗的急性髓系白血病中性粒细胞减少患者中的临床应用：病例系列
Diagnostics (Basel). 2025 Jul 5;15(13):1715. doi: 10.3390/diagnostics15131715.
3
Highly elevated sepsis biomarkers in advanced cholangiocarcinoma without sepsis: A case report and literature review.晚期胆管癌无脓毒症时脓毒症生物标志物高度升高：一例报告及文献综述
Medicine (Baltimore). 2025 May 23;104(21):e42115. doi: 10.1097/MD.0000000000042115.
4
Multidrug-Resistant and its Role in Carcinogenesis: A Scoping Review.多重耐药性及其在致癌作用中的作用：一项范围综述。
Malays J Med Sci. 2025 Feb;32(1):6-15. doi: 10.21315/mjms-09-2024-691. Epub 2025 Feb 28.
5
Clinical application of targeted next-generation sequencing in pneumonia diagnosis among cancer patients.靶向二代测序在癌症患者肺炎诊断中的临床应用
Front Cell Infect Microbiol. 2025 Feb 18;15:1497198. doi: 10.3389/fcimb.2025.1497198. eCollection 2025.
6
Diagnostic tests for infections in critically ill immunocompromised patients.危重症免疫功能低下患者感染的诊断检测
Intensive Care Med. 2024 Nov;50(11):1920-1922. doi: 10.1007/s00134-024-07647-6. Epub 2024 Sep 19.
7
High mortality associated with inappropriate initial antibiotic therapy in hematological malignancies with Klebsiella pneumoniae bloodstream infections.高死亡率与血液感染肺炎克雷伯菌的血液恶性肿瘤初始抗生素治疗不当有关。
Sci Rep. 2024 Jun 6;14(1):13041. doi: 10.1038/s41598-024-63864-5.
8
Analytical and clinical evaluation of the cobas Epstein-Barr virus test at a tertiary care cancer hospital.在一家三级癌症医院对 cobas Epstein-Barr 病毒检测进行分析和临床评估。
J Clin Virol. 2024 Aug;173:105680. doi: 10.1016/j.jcv.2024.105680. Epub 2024 Apr 29.
9
A Systematic Literature Review to Identify Diagnostic Gaps in Managing Immunocompromised Patients With Cancer and Suspected Infection.一项系统性文献综述，旨在确定免疫功能低下癌症患者合并疑似感染管理中的诊断差距。
Open Forum Infect Dis. 2023 Dec 7;11(1):ofad616. doi: 10.1093/ofid/ofad616. eCollection 2024 Jan.
10
Hypoxia-Directed and Self-Immolative Theranostic Agent: Imaging and Treatment of Cancer and Bacterial Infections.缺氧导向型自降解治疗剂：癌症和细菌感染的成像与治疗。
J Med Chem. 2023 Oct 26;66(20):14175-14187. doi: 10.1021/acs.jmedchem.3c01274. Epub 2023 Oct 12.
本文引用的文献
1
Implementation of Molecular Surveillance After a Cluster of Fatal Toxoplasmosis at 2 Neighboring Transplant Centers.两个相邻移植中心发生致命性弓形虫病聚集性病例后实施分子监测
Clin Infect Dis. 2016 Aug 15;63(4):565-8. doi: 10.1093/cid/ciw330. Epub 2016 May 19.
2
Legionellosis in Transplantation.移植中的军团菌病
Curr Infect Dis Rep. 2016 Mar;18(3):9. doi: 10.1007/s11908-016-0517-x.
3
Astrovirus outbreak at a pediatric hematology and hematopoietic stem cell transplant unit despite strict hygiene rules.尽管有严格的卫生规定，一家儿科血液学和造血干细胞移植单位仍爆发了星状病毒疫情。
Bone Marrow Transplant. 2016 May;51(5):747-50. doi: 10.1038/bmt.2015.337. Epub 2016 Jan 25.
4
The incidence, mortality and timing of Pneumocystis jiroveci pneumonia after hematopoietic cell transplantation: a CIBMTR analysis.造血细胞移植后耶氏肺孢子菌肺炎的发病率、死亡率及发病时间：一项国际骨髓移植登记处（CIBMTR）分析
Bone Marrow Transplant. 2016 Apr;51(4):573-80. doi: 10.1038/bmt.2015.316. Epub 2016 Jan 4.
5
Comparison of respiratory virus shedding by conventional and molecular testing methods in patients with haematological malignancy.血液系统恶性肿瘤患者中传统检测方法与分子检测方法对呼吸道病毒脱落情况的比较。
Clin Microbiol Infect. 2016 Apr;22(4):380.e1-380.e7. doi: 10.1016/j.cmi.2015.12.012. Epub 2015 Dec 19.
6
Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America.《念珠菌病管理临床实践指南：美国传染病学会2016年更新版》
Clin Infect Dis. 2016 Feb 15;62(4):e1-50. doi: 10.1093/cid/civ933. Epub 2015 Dec 16.
7
Parainfluenza virus infections in hematopoietic cell transplant recipients and hematologic malignancy patients: A systematic review.造血细胞移植受者和血液系统恶性肿瘤患者的副流感病毒感染：一项系统综述。
Cancer Lett. 2016 Jan 28;370(2):358-64. doi: 10.1016/j.canlet.2015.11.014. Epub 2015 Nov 12.
8
Risk factors and impact of non-Aspergillus mold infections following allogeneic HCT: a CIBMTR infection and immune reconstitution analysis.异基因造血干细胞移植后非曲霉菌霉菌感染的危险因素及影响：一项CIBMTR感染与免疫重建分析
Bone Marrow Transplant. 2016 Feb;51(2):277-82. doi: 10.1038/bmt.2015.263. Epub 2015 Nov 2.
9
Atypical presentation of Legionella pneumonia among patients with underlying cancer: A fifteen-year review.癌症患者中军团菌肺炎的非典型表现：一项十五年回顾
J Infect. 2016 Jan;72(1):45-51. doi: 10.1016/j.jinf.2015.10.006. Epub 2015 Oct 20.
10
High Incidence of Afebrile Bloodstream Infection Detected by Surveillance Blood Culture in Patients on Corticosteroid Therapy after Allogeneic Hematopoietic Stem Cell Transplantation.异基因造血干细胞移植后接受糖皮质激素治疗的患者中，通过监测血培养检测到的无发热性血流感染发生率较高。
Biol Blood Marrow Transplant. 2016 Feb;22(2):371-377. doi: 10.1016/j.bbmt.2015.09.019. Epub 2015 Sep 28.
Zotero 插件