McCarthy Matthew W, Petraitiene Ruta, Walsh Thomas J
Division of General Internal Medicine, Weill Cornell Medicine of Cornell University, New York, NY 10065, USA.
Transplantation-Oncology Infectious Diseases Program, Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine of Cornell University, New York, NY 10065, USA.
Int J Mol Sci. 2017 May 24;18(6):1124. doi: 10.3390/ijms18061124.
Early diagnosis and prompt initiation of appropriate antimicrobial therapy are crucial steps in the management of patients with invasive fungal infections. However, the diagnosis of invasive mycoses remains a major challenge in clinical practice, because presenting symptoms may be subtle and non-invasive diagnostic assays often lack sensitivity and specificity. Diagnosis is often expressed on a scale of probability (proven, probable and possible) based on a constellation of imaging findings, microbiological tools and histopathology, as there is no stand-alone assay for diagnosis. Recent data suggest that the carbohydrate biomarker (1→3)-β-d-glucan may be useful in both the diagnosis and therapeutic monitoring of invasive fungal infections due to some yeasts, molds, and dimorphic fungi. In this paper, we review recent advances in the use of (1→3)-β-d-glucan to monitor clinical response to antifungal therapy and explore how this assay may be used in the future.
早期诊断并及时启动适当的抗微生物治疗是侵袭性真菌感染患者管理中的关键步骤。然而，侵袭性真菌病的诊断在临床实践中仍然是一项重大挑战，因为临床表现可能不明显，且非侵入性诊断检测方法往往缺乏敏感性和特异性。由于没有单一的诊断检测方法，诊断通常基于一系列影像学检查结果、微生物学检测手段和组织病理学检查，按照可能性大小（确诊、很可能、可能）来表述。最近的数据表明，碳水化合物生物标志物（1→3）-β-D-葡聚糖可能有助于诊断某些酵母菌、霉菌和双相真菌引起的侵袭性真菌感染，并用于治疗监测。在本文中，我们综述了（1→3）-β-D-葡聚糖在监测抗真菌治疗临床反应方面的最新进展，并探讨该检测方法未来的应用前景。
