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侵袭性念珠菌病:非培养基础诊断的未来方向。

Invasive candidiasis: future directions in non-culture based diagnosis.

机构信息

a Division of Hygiene and Medical Microbiology , Medical University of Innsbruck , Innsbruck , Austria.

出版信息

Expert Rev Anti Infect Ther. 2017 Sep;15(9):829-838. doi: 10.1080/14787210.2017.1370373. Epub 2017 Sep 7.

Abstract

Delayed initial antifungal therapy is associated with high mortality rates caused by invasive candida infections, since accurate detection of the opportunistic pathogenic yeast and its identification display a diagnostic challenge. diagnosis of candida infections relies on time-consuming methods such as blood cultures, serologic and histopathologic examination. to allow for fast detection and characterization of invasive candidiasis, there is a need to improve diagnostic tools. trends in diagnostics switch to non-culture-based methods, which allow specified diagnosis within significantly shorter periods of time in order to provide early and appropriate antifungal treatment. Areas covered: within this review comprise novel pathogen- and host-related testing methods, e.g. multiplex-PCR analyses, T2 magnetic resonance, fungus-specific DNA microarrays, microRNA characterization or analyses of IL-17 as biomarker for early detection of invasive candidiasis. Expert commentary: Early recognition and diagnosis of fungal infections is a key issue for improved patient management. As shown in this review, a broad range of novel molecular based tests for the detection and identification of Candida species is available. However, several assays are in-house assays and lack standardization, clinical validation as well as data on sensitivity and specificity. This underscores the need for the development of faster and more accurate diagnostic tests.

摘要

延迟初始抗真菌治疗与由侵袭性念珠菌感染引起的高死亡率相关,因为准确检测机会性致病酵母及其鉴定具有诊断挑战。念珠菌感染的诊断依赖于耗时的方法,如血液培养、血清学和组织病理学检查。为了能够快速检测和表征侵袭性念珠菌病,需要改进诊断工具。诊断的趋势转向基于非培养的方法,这些方法可以在显著更短的时间内进行特定诊断,以便提供早期和适当的抗真菌治疗。涵盖领域:在本综述中包括新的病原体和宿主相关的检测方法,例如多重 PCR 分析、T2 磁共振、真菌特异性 DNA 微阵列、miRNA 特征或 IL-17 作为早期检测侵袭性念珠菌病的生物标志物的分析。专家评论:早期识别和诊断真菌感染是改善患者管理的关键问题。如本综述所示,有多种用于检测和鉴定念珠菌属的新型基于分子的检测方法。然而,一些检测方法是内部检测方法,缺乏标准化、临床验证以及关于灵敏度和特异性的数据。这凸显了开发更快、更准确的诊断测试的必要性。

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