Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Division of Infectious Diseases, ECMM Excellence Center, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
Expert Rev Mol Diagn. 2024 Sep;24(9):841-858. doi: 10.1080/14737159.2024.2397515. Epub 2024 Sep 18.
Advances in diagnostic technologies, particularly Point-of-Care Diagnostics (POCDs), have revolutionized clinical practice by providing rapid, user-friendly, and affordable testing at or near the patient's location. POCDs have been increasingly introduced in medical mycology and hold promise to improve patient outcomes in a variety of important human fungal diseases.
This review focuses on validated POCDs, particularly lateral flow assays (LFAs), for various fungal diseases. Additionally, we discuss emerging innovative techniques such as body fluid analysis, imaging methods, loop-mediated isothermal amplification (LAMP), microfluidic systems, clustered regularly interspaced short palindromic repeats (CRISPR)-based diagnostics, and the emerging role of artificial intelligence.
Compact and user-friendly POCDs have been increasingly introduced in medical mycology, and some of these tests (e.g. and antigen LFAs) have become mainstream diagnostics, while others, such as LFA in invasive aspergillosis show promise to become part of our routine diagnostic armamentarium. POCDs offer immense benefits such as timely and accurate diagnostic results, reduced patient discomfort, and lower healthcare costs and might contribute to antifungal stewardship. Integrated fluidics combined with microtechnology having multiplex capabilities will be pivotal in medical mycology.
诊断技术的进步,特别是即时诊断(POCD),通过在患者所在地或附近提供快速、用户友好且经济实惠的检测,彻底改变了临床实践。POCD 已在医学真菌学中得到越来越多的应用,并有望改善各种重要的人类真菌感染性疾病的患者预后。
本文重点介绍了各种真菌病的经过验证的 POCD,特别是侧向流动检测(LFA)。此外,我们还讨论了新兴的创新技术,如体液分析、成像方法、环介导等温扩增(LAMP)、微流控系统、簇状规律间隔短回文重复(CRISPR)为基础的诊断技术,以及人工智能的新兴作用。
紧凑型用户友好型 POCD 已在医学真菌学中得到越来越多的应用,其中一些检测(如 1,3-β-D-葡聚糖和半乳甘露聚糖 LFA)已成为主流诊断方法,而其他检测方法(如侵袭性曲霉病的 LFA)则有望成为我们常规诊断工具的一部分。POCD 具有许多优势,如及时准确的诊断结果、减轻患者不适和降低医疗保健成本,并可能有助于抗真菌药物管理。集成流体学与具有多重功能的微技术相结合,将在医学真菌学中发挥关键作用。