Department I for Internal Medicine, Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany.
CECAD Cluster of Excellence, University of Cologne, Cologne, Germany.
Mycoses. 2018 Nov;61(11):833-836. doi: 10.1111/myc.12820. Epub 2018 Jul 13.
Invasive pulmonary aspergillosis is a serious threat to immunocompromised and critical care patients. Recent detailed guidelines and treatment algorithms lead microbiologists and clinicians in diagnosis and treatment of invasive aspergillosis. Currently, there is no tool available that allows to measure guideline adherence. To develop such a tool, we reviewed current guidelines provided by five scientific societies (European Society for Clinical Microbiology and Infectious Diseases, European Confederation of Medical Mycology, European Respiratory Society, Infectious Diseases Society of America (IDSA), and Infectious Diseases Working Party of the German Society for Hematology and Medical Oncology) and selected the strongest recommendations for management as key components for our scoring tool. We integrated diagnostic measures (chest computed tomography, bronchoalveolar lavage with galactomannan, fungal culture, fungal polymerase chain reaction analysis, species identification, susceptibility testing, histology with silver stain, Periodic acid-Schiff staining, and molecular diagnostics), treatment (antifungal choice and therapeutic drug monitoring), and follow-up computed tomography. The EQUAL Aspergillosis Score 2018 aggregates and weighs the components and provides a tool to support antifungal stewardship and to quantify guideline adherence.
侵袭性肺曲霉病是免疫功能低下和重症监护患者的严重威胁。最近详细的指南和治疗算法为微生物学家和临床医生提供了侵袭性曲霉病的诊断和治疗方法。目前，没有可用的工具来衡量指南的依从性。为了开发这样的工具，我们回顾了五个科学协会（欧洲临床微生物学和传染病学会、欧洲医学真菌学联合会、欧洲呼吸学会、美国传染病学会（IDSA）和德国血液学和肿瘤学学会传染病工作组）提供的当前指南，并选择了管理的最强建议作为我们评分工具的关键组成部分。我们整合了诊断措施（胸部计算机断层扫描、半乳甘露聚糖支气管肺泡灌洗、真菌培养、真菌聚合酶链反应分析、菌种鉴定、药敏试验、银染组织学、过碘酸雪夫染色和分子诊断）、治疗（抗真菌药物选择和治疗药物监测）和随访计算机断层扫描。EQUAL 曲霉病评分 2018 对各组成部分进行了汇总和加权，为抗真菌药物管理提供了工具，并量化了指南的依从性。
