Hill Joshua A, Park Sarah Y, Gajurel Kiran, Taplitz Randy
Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA.
Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA.
Open Forum Infect Dis. 2023 Dec 7;11(1):ofad616. doi: 10.1093/ofid/ofad616. eCollection 2024 Jan.
Patients with cancer are increasingly vulnerable to infections, which may be more severe than in the general population. Improvements in rapid and timely diagnosis to optimize management are needed. We conducted a systematic literature review to determine the unmet need in diagnosing acute infections in immunocompromised patients with cancer and identified 50 eligible studies from 5188 records between 1 January 2012 and 23 June 2022. There was considerable heterogeneity in study designs and parameters, laboratory methods and definitions, and assessed outcomes, with limited evaluation of diagnostic impact on clinical outcomes. Culture remains the primary diagnostic strategy. Fewer studies employing molecular technologies exist, but emerging literature suggests that pathogen-agnostic molecular tests may add to the diagnostic armamentarium. Well-designed clinical studies using standardized methodologies are needed to better evaluate performance characteristics and clinical and economic impacts of emerging diagnostic techniques to improve patient outcomes.
癌症患者越来越容易受到感染，且感染可能比普通人群更为严重。需要改进快速及时的诊断方法以优化治疗管理。我们进行了一项系统的文献综述，以确定免疫功能低下的癌症患者在诊断急性感染方面未满足的需求，并从2012年1月1日至2022年6月23日的5188条记录中筛选出50项符合条件的研究。研究设计和参数、实验室方法和定义以及评估结果存在相当大的异质性，对诊断对临床结果的影响评估有限。培养仍然是主要的诊断策略。采用分子技术的研究较少，但新出现的文献表明，病原体非特异性分子检测可能会增加诊断手段。需要开展设计良好的、采用标准化方法的临床研究，以更好地评估新兴诊断技术的性能特征以及临床和经济影响，从而改善患者预后。
