Current challenges in the management of invasive fungal infections
Current challenges in the management of invasive fungal infections
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DOI：
10.1007/s10156-007-0595-7
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发表时间：
2008-04-01
影响因子：
2.2
通讯作者：
Hsuch, Po-Ren
中科院分区：
文献类型：
--
作者：
Lai, Chih-Cheng;Tan, Che-Kim;Hsuch, Po-Ren
侵袭性真菌感染（IFIs）的发病率在过去二十年中有所增加，因为处于危险中的患者人数持续增加。早期和准确的诊断以及随后使用适当的抗真菌治疗是困难的，这导致IFI患者的高死亡率。随着抗真菌预防的广泛应用，侵袭性真菌病原体的流行病学发生了变化。非白色念珠菌、非曲霉菌和曲霉以外的霉菌已成为引起侵袭性疾病的更常见病原体，这些新出现的真菌大多数对标准抗真菌药物具有抗性或不那么敏感。因此，这些以前罕见的真菌引起的侵袭性感染更难治疗。更有效和毒性更小的抗真菌药物的进展，如第二代三唑和棘白菌素，可能会改善这些感染的结果。在检测真菌细胞壁成分和基因组DNA方面的最新进展也使早期诊断成为可能。本文回顾了侵袭性真菌感染的变化谱，介绍了诊断工具和抗真菌药物的最新进展。
The incidence of invasive fungal infections (IFIs) has increased over the past two decades, as the populations of patients at risk have continued to rise. Early and accurate diagnosis and the subsequent usage of appropriate antifungal therapy are difficult, which leads to a high mortality rate in patients with IFI. Along with the widespread use of antifungal prophylaxis, the epidemiology of invasive fungal pathogens has changed. Non-albicans Candida, Non-fumigatus Aspergithis, and molds other than Aspergillus have become more common pathogens causing invasive diseases, and most of these emerging fungi are resistant to or less susceptible than others to standard antifungal agents. Therefore, invasive infections due to these previously rare fungi are more difficult to treat. Advances in more potent and less toxic antifungal agents, such as second-generation triazoles and echinocandins, may potentially improve the outcomes of these infections. Recent advances in detecting fungal cell-wall components and genomic DNA also allow earlier diagnosis. Ibis article reviews the changing spectrum of invasive fungal infections and the introduction of recent advances in diagnostic tools and antifungal agents.