Infectious Diseases Unit, Ospedale Policlinico San Martino-IRCCS, Genoa, Italy.
Department of Health Sciences, University of Genoa, Genoa, Italy.
Clin Infect Dis. 2021 Mar 12;72(Suppl 2):S121-S127. doi: 10.1093/cid/ciaa1751.
The EORTC/MSGERC recently revised and updated the consensus definitions of invasive fungal disease (IFD). These definitions primarily focus on patients with cancer and stem cell or solid-organ transplant patients. They may therefore not be suitable for intensive care unit (ICU) patients. More in detail, while the definition of proven IFD applies to a broad range of hosts, the categories of probable and possible IFD were primarily designed for classical immunocompromised hosts and may therefore not be ideal for other populations. Moreover, the scope of the possible category of IFD has been diminished in the recently revised definitions for classically immunocompromised hosts. Diagnosis of IFD in the ICU presents many challenges, which are different for invasive candidiasis and for invasive aspergillosis. The aim of this article is to review progresses made in recent years and difficulties remaining in the development of definitions applicable in the ICU setting.
欧洲癌症研究与治疗组织/侵袭性真菌病研究协作组最近修订并更新了侵袭性真菌病(IFD)的共识定义。这些定义主要针对癌症患者和干细胞或实体器官移植患者。因此,它们可能不适合重症监护病房(ICU)患者。更详细地说,虽然确诊 IFD 的定义适用于广泛的宿主,但可能和疑似 IFD 的类别主要是为经典免疫功能低下的宿主设计的,因此对于其他人群可能并不理想。此外,在最近修订的针对经典免疫功能低下宿主的 IFD 可能类别定义中,IFD 的范围已经缩小。在 ICU 中诊断 IFD 存在许多挑战,侵袭性念珠菌病和侵袭性曲霉菌病的挑战有所不同。本文的目的是回顾近年来的进展以及在 ICU 环境中应用的定义制定方面仍然存在的困难。