Department of Pathology and Laboratory Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
Clin Chem. 2021 Dec 30;68(1):83-90. doi: 10.1093/clinchem/hvab217.
Infections caused by fungi can be important causes of morbidity and mortality in certain patient populations, including those who are highly immunocompromised or critically ill. Invasive mycoses can be caused by well-known species, as well as emerging pathogens, including those that are resistant to clinically available antifungals.
This review highlights emerging fungal infections, including newly described species, such as Candida auris, and those that having undergone taxonomic classification and were previously known by other names, including Blastomyces and Emergomyces species, members of the Rasamsonia argillacea species complex, Sporothrix brasiliensis, and Trichophyton indotinae. Antifungal resistance also is highlighted in several of these emerging species, as well as in the well-known opportunistic pathogen Aspergillus fumigatus. Finally, the increased recognition and importance of fungal co-infections with respiratory pathogens, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is discussed.
Both clinicians and clinical microbiology laboratories should remain vigilant regarding emerging fungal infections. These may be difficult both to diagnose and treat due to the lack of experience of clinicians and laboratory personnel with these organisms and the infections they may cause. Many of these fungal infections have been associated with poor clinical outcomes, either due to inappropriate therapy or the development of antifungal resistance.
真菌感染可成为某些特定患者群体（包括高度免疫功能低下或病重的患者）发病和死亡的重要原因。侵袭性真菌感染可由知名菌种引起，也可由新兴病原体引起，包括对现有临床可用抗真菌药物具有耐药性的病原体。
本综述重点介绍了新发真菌感染，包括新描述的菌种，如耳念珠菌，以及经过分类学分类、以前用其他名称描述的菌种，如芽生菌属和隐球菌属、泥裂丝孢菌种复合体中的 Rasamsonia argillacea 种、巴西利什曼原虫和地霉属 indotinae 种。在其中几种新发菌种中，以及在知名的机会性致病真菌烟曲霉中，也出现了抗真菌耐药性。最后，还讨论了与呼吸道病原体（包括严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2)）的真菌合并感染日益受到重视的情况。
临床医生和临床微生物学实验室都应持续关注新发真菌感染。由于临床医生和实验室人员对这些生物体及其可能引起的感染缺乏经验，这些感染可能难以诊断和治疗。许多这些真菌感染与不良临床结局相关，要么是由于治疗不当，要么是由于出现了抗真菌耐药性。
