Division of Infectious Diseases, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Division of Infectious Diseases and Tropical Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Antimicrob Chemother. 2022 Sep 30;77(10):2579-2585. doi: 10.1093/jac/dkac251.
Management of invasive mould infections (IMIs) is challenging in Asia, as awareness among medical practitioners can be low and resources are limited. Timely diagnosis and appropriate treatment of IMIs can mitigate the impact on morbidity and mortality, but diagnostic methods, as well as access to preferred antifungal medications, may vary throughout the region. Knowledge of local epidemiology and accurate diagnosis and identification of causal pathogens would facilitate optimal treatment but data in Asia are lacking. To address these unmet needs in the management of IMIs, this paper is a call for urgent action in the following areas: improving awareness of the threat of IMIs; providing education to frontline clinicians across a broad range of specialties on 'red flags' for suspicion of IMIs; prioritizing cost-effective rapid diagnostic testing; improving access to preferred antifungal medications; and closing the gaps in local epidemiological data on IMIs to inform local treatment guidelines.
亚洲侵袭性霉菌感染(IMI)的管理极具挑战,因为医务人员的意识可能较低,资源也有限。及时诊断和适当的治疗侵袭性霉菌感染可以减轻发病率和死亡率的影响,但诊断方法以及获得首选抗真菌药物的机会在该地区可能存在差异。了解当地的流行病学情况以及准确诊断和识别致病病原体有助于实现最佳治疗效果,但亚洲的数据却很缺乏。为了解决侵袭性霉菌感染管理方面这些未满足的需求,本文呼吁在以下领域采取紧急行动:提高对侵袭性霉菌感染威胁的认识;为广泛的专科一线临床医生提供关于侵袭性霉菌感染“预警信号”的教育;优先考虑经济有效的快速诊断检测;改善获得首选抗真菌药物的机会;并填补侵袭性霉菌感染当地流行病学数据的空白,以为当地治疗指南提供信息。