Kanaujia Rimjhim, Singh Shreya, Rudramurthy Shivaprakash M
Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research PGIMER, Chandigarh, India.
Department of Microbiology, Dr B R Ambedkar State Institute of Medical Sciences (AIMS), Mohali, Punjab India.
Curr Fungal Infect Rep. 2023 May 4:1-12. doi: 10.1007/s12281-023-00461-5.
This review gives an overview of the diseases caused by , including a description of the species involved and the infected clinical systems. We provide insight into the various diagnostic methods available for diagnosing aspergillosis, particularly invasive aspergillosis (IA), including the role of radiology, bronchoscopy, culture, and non-culture-based microbiological methods. We also discuss the available diagnostic algorithms for the different disease conditions. This review also summarizes the main aspects of managing infections due to spp., such as antifungal resistance, choice of antifungals, therapeutic drug monitoring, and new antifungal alternatives.
The risk factors for this infection continue to evolve with the development of many biological agents that target the immune system and the increase of viral illnesses such as coronavirus disease. Due to the limitations of present mycological test methods, establishing a fast diagnosis is frequently difficult, and reports of developing antifungal resistance further complicate the management of aspergillosis. Many commercial assays, like AsperGenius®, MycAssay Aspergillus®, and MycoGENIE®, have the advantage of better species-level identification and concomitant resistance-associated mutations. Fosmanogepix, ibrexafungerp, rezafungin, and olorofim are newer antifungal agents in the pipeline exhibiting remarkable activity against spp.
The fungus is found ubiquitously around the world and can cause various infections, from harmless saprophytic colonization to severe IA. Understanding the diagnostic criteria to be used in different patient groups and the local epidemiological data and antifungal susceptibility profile is critical for optimal patient management.
本综述概述了由曲霉属引起的疾病，包括所涉及的菌种描述以及受感染的临床系统。我们深入探讨了可用于诊断曲霉病，特别是侵袭性曲霉病（IA）的各种诊断方法，包括放射学、支气管镜检查、培养以及非基于培养的微生物学方法的作用。我们还讨论了针对不同疾病状况的可用诊断算法。本综述还总结了曲霉属感染管理的主要方面，如抗真菌耐药性、抗真菌药物的选择、治疗药物监测以及新的抗真菌替代药物。
随着许多靶向免疫系统的生物制剂的研发以及冠状病毒病等病毒性疾病的增加，这种感染的危险因素不断演变。由于目前真菌学检测方法的局限性，快速诊断常常困难，而且抗真菌耐药性的报道使曲霉病的管理更加复杂。许多商业检测方法，如AsperGenius®、MycAssay Aspergillus®和MycoGENIE®，具有更好的菌种水平鉴定以及伴随的耐药相关突变检测的优势。福沙那韦、ibrexafungerp、瑞扎芬净和奥洛罗芬是正在研发的新型抗真菌药物，对曲霉属表现出显著活性。
曲霉属真菌在世界各地普遍存在，可引起从无害的腐生定植到严重IA的各种感染。了解不同患者群体应采用的诊断标准以及当地的流行病学数据和抗真菌药敏情况对于优化患者管理至关重要。
