Section of Infectious Diseases and Global Health, The University of Chicago, 5841 South Maryland Avenue, MC5065, Chicago, IL 60637, USA.
Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine, 315 Trent Drive, Durham, NC 27705, USA.
Infect Dis Clin North Am. 2023 Sep;37(3):593-616. doi: 10.1016/j.idc.2023.05.001.
Recently, there have been significant advances in the diagnosis and management of invasive fungal infections. Compared with traditional fungal diagnostics, molecular assays promise improved sensitivity and specificity, the ability to test a range of samples (including noninvasive samples, ie, blood), the detection of genetic mutations associated with antifungal resistance, and the potential for a faster turnaround time. Antifungals in late-stage clinical development include agents with novel mechanisms of action (olorofim and fosmanogepix) and new members of existing classes with distinct advantages over existing antifungals in toxicity, drug-drug interactions, and dosing convenience (oteseconazole, opelconazole, rezafungin, ibrexafungerp, encochleated amphotericin B).
近年来,侵袭性真菌感染的诊断和治疗取得了重大进展。与传统的真菌诊断方法相比,分子检测具有更高的灵敏度和特异性,能够检测多种样本(包括非侵入性样本,如血液),检测与抗真菌药物耐药性相关的基因突变,以及更快的周转时间。处于临床开发后期的抗真菌药物包括具有新型作用机制的药物(olorofim 和 fosmanogepix)和现有类别中的新成员,它们在毒性、药物相互作用和用药便利性方面与现有抗真菌药物相比具有明显优势(oterconazole、opelconazole、rezafungin、ibrexafungerp、包封两性霉素 B)。