Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore, 308232, Singapore.
Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore, Singapore.
Mycopathologia. 2020 Apr;185(2):207-231. doi: 10.1007/s11046-019-00413-z. Epub 2020 Jan 1.
Fungal disease is an increasingly recognised global clinical challenge associated with high mortality. Early diagnosis of fungal infection remains problematic due to the poor sensitivity and specificity of current diagnostic modalities. Advances in sequencing technologies hold promise in addressing these shortcomings and for improved fungal detection and identification. To translate such emerging approaches into mainstream clinical care will require refinement of current sequencing and analytical platforms, ensuring standardisation and consistency through robust clinical benchmarking and its validation across a range of patient populations. In this state-of-the-art review, we discuss current diagnostic and therapeutic challenges associated with fungal disease and provide key examples where the application of sequencing technologies has potential diagnostic application in assessing the human 'mycobiome'. We assess how ready access to fungal sequencing may be exploited in broadening our insight into host-fungal interaction, providing scope for clinical diagnostics and the translation of emerging mycobiome research into clinical practice.
真菌感染是一个日益受到重视的全球性临床挑战，其死亡率很高。由于目前的诊断方法灵敏度和特异性较差，真菌感染的早期诊断仍然存在问题。测序技术的进步有望解决这些缺点，并提高真菌检测和鉴定的准确性。要将这些新兴方法转化为主流临床护理，需要改进当前的测序和分析平台，通过稳健的临床基准测试和在一系列患者群体中的验证来确保标准化和一致性。在这篇最新综述中，我们讨论了与真菌感染相关的当前诊断和治疗挑战，并提供了关键示例，其中测序技术的应用在评估人类“真菌组”方面具有潜在的诊断应用。我们评估了获得真菌测序的便捷程度如何能够帮助我们更深入地了解宿主-真菌相互作用，为临床诊断提供了空间，并将新兴的真菌组研究转化为临床实践。
