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血液肿瘤患者侵袭性肺曲霉病诊断和治疗的循证临床标准

Evidence-based clinical standard for the diagnosis and treatment of invasive lung aspergillosis in the patient with oncohematologic disease.

作者信息

Cortés Jorge Alberto, Rodríguez-Lugo Diego Andrés, Valderrama-Rios Martha Carolina, Rabagliati Ricardo, Capone Domenico, Álvarez-Moreno Carlos Arturo, Varón-Vega Fabio, Nocua-Báez Laura Cristina, Diaz-Brochero Cándida, Enciso Olivera Leonardo, Cuervo-Maldonado Sonia Isabel, Thompson Luis, Corzo-León Dora E, Cuéllar Luis E, Vergara Erika Paola, Riera Fernando, Cornejo-Juárez Patricia, Rojas Rita, Gómez Beatriz L, Celis-Ramírez Adriana Marcela, Sandoval-Gutiérrez José Luis, Sarmiento Mauricio, Ochoa Diana Lorena, Nucci Marcio

机构信息

Universidad Nacional de Colombia, Facultad de Medicina, Departamento de Medicina Interna, Bogotá, Colombia; Hospital Universitario Nacional de Colombia, Unidad de Infectología, Bogotá, Colombia.

Universidad Nacional de Colombia, Facultad de Medicina, Departamento de Medicina Interna, Bogotá, Colombia.

出版信息

Braz J Infect Dis. 2025 Mar-Apr;29(2):104517. doi: 10.1016/j.bjid.2025.104517. Epub 2025 Feb 24.

Abstract

Aspergillosis is a disease caused by the filamentous fungus Aspergillus spp. with a spectrum of clinical presentation that includes invasive and noninvasive forms. The invasive clinical presentation of aspergillosis most frequently affects people with compromised immune systems. In patients with oncohematologic pathology, invasive lung aspergillosis is a significant opportunistic mycosis, because it occurs frequently and has a major impact on morbidity, mortality, and high costs. The global problem of antimicrobial resistance, to which improper use of antifungals contributes, has put Aspergilus spp. in the spotlight, so it is important to generate guidelines for guidance in the proper use of antifungals in the management of invasive lung aspergillosis, to obtain better clinical outcomes and promote rational use of antifungals. This guideline contains recommendations for diagnosing and treating invasive lung aspergillosis in patients with oncohematologic disease, based on evidence and defined through a participatory process of expert consensus, for the Latin American context.

摘要

曲霉病是一种由丝状真菌曲霉属引起的疾病,临床表现多样,包括侵袭性和非侵袭性形式。曲霉病的侵袭性临床表现最常影响免疫系统受损的人群。在肿瘤血液学疾病患者中,侵袭性肺曲霉病是一种重要的机会性真菌病,因为它频繁发生,对发病率、死亡率和高昂成本有重大影响。抗菌药物耐药性这一全球性问题(不当使用抗真菌药物也对此有推动作用)已使曲霉属备受关注,因此制定在侵袭性肺曲霉病管理中正确使用抗真菌药物的指导方针很重要,以便获得更好的临床结果并促进抗真菌药物的合理使用。本指南包含基于证据并通过专家共识参与过程确定的针对拉丁美洲背景下肿瘤血液学疾病患者侵袭性肺曲霉病的诊断和治疗建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a009/11903820/cb177c6d2017/gr1.jpg

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