Division of General Internal Medicine, Department of Medicine, University of California San Diego , La Jolla, CA, USA.
Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego , La Jolla, CA, USA.
Expert Rev Mol Diagn. 2020 Oct;20(10):1009-1017. doi: 10.1080/14737159.2020.1820864. Epub 2020 Sep 14.
The spectrum of disease caused by spp. is dependent on the immune system of the host, with invasive aspergillosis (IA) its most severe manifestation. Early and reliable diagnosis of disease is important to decrease associated morbidity and mortality from IA.
The following review searched Pub Med for literature published since 2007 and will give an update on the current point-of-care diagnostic strategies for the diagnosis of IA, discuss needed areas of improvement for these tests, and future directions.
Several new diagnostic tests for IA - including point-of-care tests - are now available to complement conventional galactomannan (GM) testing. In particular, the -specific Lateral Flow Device (LFD) test and the sōna GM Lateral Flow Assay (LFA) are promising for the diagnosis of IA in patients with hematologic malignancy, although further evaluation in the non-hematology setting is needed. In addition, a true point-of-care test, particularly for easily obtained specimens like serum or urine that can be done at the bedside or in the Clinic in a matter of minutes is needed, such as the lateral flow dipstick test, which is under current evaluation. Lastly, improved diagnostic algorithms to diagnose IA in non-neutropenic patients is needed.
spp.引起的疾病谱取决于宿主的免疫系统,侵袭性曲霉病(IA)是其最严重的表现。早期和可靠的诊断对于降低与 IA 相关的发病率和死亡率非常重要。
本次综述在 PubMed 上搜索了自 2007 年以来发表的文献,并将更新当前用于诊断 IA 的即时诊断策略,讨论这些检测方法需要改进的领域以及未来的方向。
目前有几种用于 IA 的新诊断检测方法,包括即时检测方法,以补充常规半乳甘露聚糖(GM)检测。特别是针对的侧向流动装置(LFD)检测和 sōna GM 侧向流动分析(LFA)在血液恶性肿瘤患者的 IA 诊断中很有前景,尽管在非血液学环境中需要进一步评估。此外,需要一种真正的即时检测方法,特别是对于易于获得的标本,如血清或尿液,可以在床边或诊所进行,在几分钟内完成,例如正在评估中的侧向流动条带检测。最后,需要改进用于诊断非中性粒细胞减少患者 IA 的诊断算法。