Chen Sharon C-A, Halliday Catriona L, Hoenigl Martin, Cornely Oliver A, Meyer Wieland
Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, New South Wales Health Pathology, Westmead Hospital, Westmead, Sydney, NSW 2145, Australia.
Marie Bashir Institute for Infectious Diseases & Biosecurity, The University of Sydney, Sydney, NSW 2006, Australia.
J Fungi (Basel). 2021 Jan 4;7(1):23. doi: 10.3390/jof7010023.
/ fungi are increasingly recognized pathogens. As these fungi are resistant to many antifungal agents, early diagnosis is essential for initiating targeted drug therapy. Here, we review the microbiological tools for the detection and diagnosis of invasive scedosporiosis and lomentosporiosis. Of over 10 species, , , and cause the majority of infections. Definitive diagnosis relies on one or more of visualization, isolation or detection of the fungus from clinical specimens by microscopy techniques, culture and molecular methods such as panfungal PCR or genus-/species-specific multiplex PCR. For isolation from respiratory tract specimens, selective media have shown improved isolation rates. Species identification is achieved by macroscopic and microscopic examination of colonies, but species should be confirmed by ITS with or without β-tubulin gene sequencing or other molecular methods. Matrix-assisted laser desorption ionization-time of flight mass spectrometry databases are improving but may need supplementation by in-house spectra for species identification. Reference broth microdilution methods is preferred for antifungal susceptibility testing. Next-generation sequencing technologies have good potential for characterization of these pathogens. Diagnosis of / infections relies on multiple approaches encompassing both phenotypic- and molecular-based methods.
真菌日益被认为是病原体。由于这些真菌对许多抗真菌药物具有抗性，早期诊断对于启动靶向药物治疗至关重要。在此，我们综述了用于检测和诊断侵袭性赛多孢子菌病和多育赛多孢子菌病的微生物学工具。在超过10种真菌中，[具体真菌名称1]、[具体真菌名称2]、[具体真菌名称3]和[具体真菌名称4]导致了大多数感染。确诊依赖于通过显微镜技术、培养以及诸如泛真菌PCR或属/种特异性多重PCR等分子方法从临床标本中可视化、分离或检测真菌中的一种或多种。对于从呼吸道标本中分离，选择性培养基已显示出提高的分离率。通过对菌落进行宏观和微观检查来实现菌种鉴定，但菌种应通过内转录间隔区（ITS）测序（有或没有β-微管蛋白基因测序）或其他分子方法来确认。基质辅助激光解吸电离飞行时间质谱数据库正在不断完善，但可能需要通过内部光谱进行补充以用于菌种鉴定。参考肉汤微量稀释法是抗真菌药敏试验的首选方法。新一代测序技术在表征这些病原体方面具有很大潜力。[具体真菌名称]感染的诊断依赖于包括基于表型和分子的方法在内的多种方法。
