Elad Daniel, Segal Esther
Department of Clinical Bacteriology and Mycology, Kimron Veterinary Institute, Bet Dagan, Israel.
Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Front Microbiol. 2018 Jun 21;9:1303. doi: 10.3389/fmicb.2018.01303. eCollection 2018.
The genus is composed of more than 300 species, a fraction of which are involved in animal or human infections mostly following environmental exposure. Various risk factors (i.e., immunosuppression, tuberculosis) have been recognized for human whereas for veterinary infections, unhygienic management, trauma, anatomical conformation of the skull, or suspected immunological deficiencies have been suggested. In animals, aspergillosis is mostly sporadic but in some circumstance such as infections on poultry farms may involve the whole flock. Since the high prevalence of immunosuppression in human patients has not been mirrored in veterinary medicine, and although to the best of our knowledge, no comprehensive data on the prevalence of aspergillosis in animals has been published, their epidemiology has not changed during the last decades. The impact of these infections may be economic or if they are incurable, sentimental. The objective of the first part is to describe the diagnosis of the main clinical entities caused by spp. in animals. It includes disseminated canine aspergillosis, canine and feline sino-nasal and sino-orbital aspergillosis, guttural pouch mycosis in horses, mycotic abortion in cattle, mycotic keratitis in horses, and avian aspergillosis. When pathogenesis and clinical aspects are relevant for diagnosis-they will be addressed as well. The second part deals with human aspergillosis, which is a multifaceted disease, manifested in a spectrum of clinical entities affecting one or more organs. Diagnosis is based on the clinical manifestation, supported and confirmed by laboratory means, involving the classical approach of demonstrating the etiological agent in the clinical specimens and in culture. Noncultural methods, such as antigen detection and/or molecular assays to detect fungal nucleic acids or protein profiles, are used as well. The isolation and identification of the fungus allows the determination of its susceptibility to antifungal drugs. Thus, antifungal susceptibility testing maybe considered as part of the diagnostic process, which is of relevance for management of the infection. In this review article, the part dealing with diagnostic aspects of aspergillosis in humans concentrates on susceptibility testing of spp. to antifungal drugs and drug combinations. The technologies and methods of susceptibility testing are described and evaluated.
该属由300多种物种组成，其中一部分会引发动物或人类感染，主要是在接触环境后。已确认多种人类感染的风险因素（如免疫抑制、结核病），而对于兽医感染，有人提出了不卫生的管理、创伤、头骨的解剖结构或疑似免疫缺陷等因素。在动物中，曲霉病大多为散发性，但在某些情况下，如家禽养殖场的感染可能会波及整个鸡群。由于人类患者中免疫抑制的高发病率在兽医学中并未出现类似情况，而且据我们所知，尚未发表关于动物曲霉病发病率的全面数据，因此在过去几十年中其流行病学情况并未改变。这些感染的影响可能是经济方面的，或者如果无法治愈，则是情感方面的。第一部分的目的是描述由曲霉属物种在动物中引起的主要临床病症的诊断。它包括播散性犬曲霉病、犬猫鼻旁窦和鼻眶曲霉病、马的咽鼓管真菌病、牛的霉菌性流产、马的霉菌性角膜炎以及禽曲霉病。当发病机制和临床方面与诊断相关时，也将予以讨论。第二部分涉及人类曲霉病，这是一种多方面的疾病，表现为一系列影响一个或多个器官的临床病症。诊断基于临床表现，并通过实验室手段得到支持和证实，包括在临床标本和培养物中证明病原体的经典方法。也使用非培养方法，如抗原检测和/或检测真菌核酸或蛋白质谱的分子检测方法。真菌的分离和鉴定可以确定其对抗真菌药物的敏感性。因此，抗真菌药敏试验可被视为诊断过程的一部分，这对于感染的管理具有重要意义。在这篇综述文章中，涉及人类曲霉病诊断方面的部分主要关注曲霉属物种对抗真菌药物和药物组合的药敏试验。描述并评估了药敏试验的技术和方法。
