Hoenigl Martin, Salmanton-García Jon, Walsh Thomas J, Nucci Marcio, Neoh Chin Fen, Jenks Jeffrey D, Lackner Michaela, Sprute Rosanne, Al-Hatmi Abdullah M S, Bassetti Matteo, Carlesse Fabianne, Freiberger Tomas, Koehler Philipp, Lehrnbecher Thomas, Kumar Anil, Prattes Juergen, Richardson Malcolm, Revankar Sanjay, Slavin Monica A, Stemler Jannik, Spiess Birgit, Taj-Aldeen Saad J, Warris Adilia, Woo Patrick C Y, Young Jo-Anne H, Albus Kerstin, Arenz Dorothee, Arsic-Arsenijevic Valentina, Bouchara Jean-Philippe, Chinniah Terrence Rohan, Chowdhary Anuradha, de Hoog G Sybren, Dimopoulos George, Duarte Rafael F, Hamal Petr, Meis Jacques F, Mfinanga Sayoki, Queiroz-Telles Flavio, Patterson Thomas F, Rahav Galia, Rogers Thomas R, Rotstein Coleman, Wahyuningsih Retno, Seidel Danila, Cornely Oliver A
Section of Infectious Diseases and Tropical Medicine, Medical University of Graz, Graz, Austria; Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, San Diego, CA, USA; Clinical and Translational Fungal Research Working Group, University of California San Diego, San Diego, CA, USA; European Confederation of Medical Mycology Council, Basel, Switzerland.
Faculty of Medicine, University of Cologne, Cologne, Germany; Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, University of Cologne, Cologne, Germany.
Lancet Infect Dis. 2021 Aug;21(8):e246-e257. doi: 10.1016/S1473-3099(20)30784-2. Epub 2021 Feb 16.
With increasing numbers of patients needing intensive care or who are immunosuppressed, infections caused by moulds other than Aspergillus spp or Mucorales are increasing. Although antifungal prophylaxis has shown effectiveness in preventing many invasive fungal infections, selective pressure has caused an increase of breakthrough infections caused by Fusarium, Lomentospora, and Scedosporium species, as well as by dematiaceous moulds, Rasamsonia, Schizophyllum, Scopulariopsis, Paecilomyces, Penicillium, Talaromyces and Purpureocillium species. Guidance on the complex multidisciplinary management of infections caused by these pathogens has the potential to improve prognosis. Management routes depend on the availability of diagnostic and therapeutic options. The present recommendations are part of the One World-One Guideline initiative to incorporate regional differences in the epidemiology and management of rare mould infections. Experts from 24 countries contributed their knowledge and analysed published evidence on the diagnosis and treatment of rare mould infections. This consensus document intends to provide practical guidance in clinical decision making by engaging physicians and scientists involved in various aspects of clinical management. Moreover, we identify areas of uncertainty and constraints in optimising this management.
随着需要重症监护或免疫抑制患者数量的增加，由曲霉属或毛霉目以外的霉菌引起的感染正在增多。尽管抗真菌预防在预防许多侵袭性真菌感染方面已显示出有效性，但选择性压力导致由镰刀菌属、罗门孢属和拟青霉属以及暗色霉菌、拉氏菌属、裂褶菌属、帚霉属、拟青霉属、青霉属、篮状菌属和紫青霉属引起的突破性感染有所增加。关于这些病原体所致感染的复杂多学科管理的指南有可能改善预后。管理途径取决于诊断和治疗选择的可用性。本建议是“同一个世界-同一个指南”倡议的一部分，旨在纳入罕见霉菌感染流行病学和管理方面的区域差异。来自24个国家的专家贡献了他们的知识，并分析了关于罕见霉菌感染诊断和治疗的已发表证据。本共识文件旨在通过让参与临床管理各个方面的医生和科学家参与，为临床决策提供实用指导。此外，我们确定了优化这种管理方面的不确定性和限制领域。
