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免疫功能低下患者感染的诊断与临床管理

Diagnostic and clinical management of infections in immunocompromised patients.

作者信息

Posteraro Brunella, Cosio Terenzio, Torelli Riccardo, De Carolis Elena, Magrì Carlotta, Posteraro Patrizia, De Angelis Giulia, Sanguinetti Maurizio

机构信息

Unità Operativa "Medicina di Precisione in Microbiologia Clinica", Direzione Scientifica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy.

出版信息

Expert Rev Anti Infect Ther. 2025 Aug;23(8):561-570. doi: 10.1080/14787210.2025.2505567. Epub 2025 May 16.

Abstract

INTRODUCTION

() is an emerging fungal pathogen that poses a significant threat to immunocompromised patients. Its high mortality rates, resistance to multiple antifungal classes, and ability to spread rapidly in healthcare settings underscore the need for timely and accurate diagnosis to guide effective clinical management.

AREAS COVERED

This special report provides an updated overview of infections in immunocompromised hosts. It discusses current phenotypic and molecular diagnostic tools, antifungal susceptibility testing methods, and infection control strategies. Emerging therapies, including investigational antifungals and combination regimens, are also examined in light of evolving resistance patterns and clinical challenges.

EXPERT OPINION

Despite notable advances in diagnostics and treatment, major obstacles remain in the clinical management of , particularly in vulnerable populations. Barriers to guideline implementation, lack of standardized screening protocols, and limited access to novel antifungal agents continue to hinder effective response. Future efforts should focus on expanding diagnostic capacity, developing innovative therapies, and implementing targeted surveillance strategies to reduce the global burden of .

摘要

引言

()是一种新兴的真菌病原体,对免疫功能低下的患者构成重大威胁。其高死亡率、对多种抗真菌药物类别的耐药性以及在医疗机构中迅速传播的能力,凸显了及时准确诊断以指导有效临床管理的必要性。

涵盖领域

本专题报告提供了免疫功能低下宿主中()感染的最新概述。它讨论了当前的表型和分子诊断工具、抗真菌药敏试验方法以及感染控制策略。还根据不断演变的耐药模式和临床挑战,对包括研究性抗真菌药物和联合治疗方案在内的新兴疗法进行了研究。

专家意见

尽管在诊断和治疗方面取得了显著进展,但在()的临床管理中,尤其是在弱势群体中,仍存在重大障碍。指南实施的障碍、缺乏标准化筛查方案以及新型抗真菌药物的获取有限,继续阻碍有效应对。未来的努力应集中在扩大诊断能力、开发创新疗法以及实施有针对性的监测策略,以减轻全球()负担。

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