Suppr超能文献

侵袭性念珠菌病的诊断与治疗

Diagnosis and Treatment of Invasive Candidiasis.

作者信息

Barantsevich Natalia, Barantsevich Elena

机构信息

Almazov National Madical Research Centre, Research Department of Microbiology and Nosocomial Indfections, Akkuratova, 2, 197341 Saint-Petersburg, Russia.

出版信息

Antibiotics (Basel). 2022 May 26;11(6):718. doi: 10.3390/antibiotics11060718.

Abstract

species, belonging to commensal microbial communities in humans, cause opportunistic infections in individuals with impaired immunity. Pathogens encountered in more than 90% cases of invasive candidiasis include , , and . The most frequently diagnosed invasive infection is candidemia. About 50% of candidemia cases result in deep-seated infection due to hematogenous spread. The sensitivity of blood cultures in autopsy-proven invasive candidiasis ranges from 21% to 71%. Non-cultural methods (beta-D-glucan, T2Candida assays), especially beta-D-glucan in combination with procalcitonin, appear promising in the exclusion of invasive candidiasis with high sensitivity (98%) and negative predictive value (95%). There is currently a clear deficiency in approved sensitive and precise diagnostic techniques. Omics technologies seem promising, though require further development and study. Therapeutic options for invasive candidiasis are generally limited to four classes of systemic antifungals (polyenes, antimetabolite 5-fluorocytosine, azoles, echinocandins) with the two latter being highly effective and well-tolerated and hence the most widely used. Principles and methods of treatment are discussed in this review. The emergence of pan-drug-resistant strains indicates an insufficient choice of available medications. Further surveillance, alongside the development of diagnostic and therapeutic methods, is essential.

摘要

这些菌种属于人体共生微生物群落,可在免疫功能受损的个体中引起机会性感染。超过90%的侵袭性念珠菌病病例中遇到的病原体包括白色念珠菌、热带念珠菌和近平滑念珠菌。最常诊断出的侵袭性感染是念珠菌血症。约50%的念珠菌血症病例会因血行播散导致深部感染。经尸检证实的侵袭性念珠菌病中血培养的敏感性为21%至71%。非培养方法(β-D-葡聚糖、T2念珠菌检测),尤其是β-D-葡聚糖与降钙素原联合使用,在排除侵袭性念珠菌病方面似乎很有前景,其敏感性高(98%)且阴性预测值高(95%)。目前,在批准的敏感且精确的诊断技术方面明显不足。组学技术似乎很有前景,不过需要进一步开发和研究。侵袭性念珠菌病的治疗选择通常限于四类全身性抗真菌药物(多烯类、抗代谢物5-氟胞嘧啶、唑类、棘白菌素类),后两类药物高效且耐受性良好,因此使用最为广泛。本综述讨论了治疗的原则和方法。泛耐药菌株的出现表明可用药物的选择不足。进一步的监测以及诊断和治疗方法的开发至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bee5/9219674/d4a05b6c3a89/antibiotics-11-00718-g001.jpg

文献检索

告别复杂PubMed语法,用中文像聊天一样搜索,搜遍4000万医学文献。AI智能推荐,让科研检索更轻松。

立即免费搜索

文件翻译

保留排版,准确专业,支持PDF/Word/PPT等文件格式,支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述,25分钟生成高质量综述,智能提取关键信息,辅助科研写作。

立即免费体验