Refractory fungal infection: Three case reports highlighting good practice

IF 1.6 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Medical Mycology Case Reports Pub Date : 2024-12-01 DOI:10.1016/j.mmcr.2024.100688
Rosemary Barnes , David A. Enoch , Wendy Ingram , Jessica Martin , Jennifer Clay , Netta Tyler , P Lewis White
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Abstract

Refractory invasive fungal disease is a significant clinical problem, with high morbidity, mortality and costs. The complex causes of refractory infection include breakthrough infection due to antifungal resistance (both innate and acquired), suboptimal therapy and impaired immune responses in critically ill or immunocompromised patients. This case series details three reports on the identification and management of refractory fungal infections, two cases of azole resistance and one case of resistant candidiasis, highlighting the importance of accurate diagnosis, monitoring, implementation of biomarkers (serological markers, PCR), antifungal susceptibility testing and antifungal stewardship to optimise management and minimise risks of emergence of drug resistance.
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难治性真菌感染:三个案例报告强调良好做法。
难治性侵袭性真菌疾病是一个重要的临床问题,具有很高的发病率、死亡率和费用。难治性感染的复杂原因包括由抗真菌耐药性(先天和获得性)引起的突破性感染、不理想的治疗以及危重患者或免疫功能低下患者的免疫反应受损。本病例系列详细介绍了三例难治性真菌感染的鉴定和管理报告,两例唑耐药性病例和一例耐药念珠菌病,强调了准确诊断、监测、生物标志物(血清学标志物、PCR)的实施、抗真菌药敏试验和抗真菌管理的重要性,以优化管理和最大限度地减少出现耐药性的风险。
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来源期刊
Medical Mycology Case Reports
Medical Mycology Case Reports MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
4.00
自引率
0.00%
发文量
48
审稿时长
47 days
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