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New and emerging roles for inhalational and direct antifungal drug delivery approaches for treatment of invasive fungal infections. 吸入式和直接抗真菌给药方法在治疗侵袭性真菌感染方面的新作用。
IF 4.2 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-09-29 DOI: 10.1080/14787210.2024.2409408
Chin Fen Neoh, Wirawan Jeong, David C M Kong, Justin Beardsley, Philip Chi Lip Kwok, Monica A Slavin, Sharon C-A Chen

Introduction: The rising prevalence of difficult-to-treat, deep-seated invasive fungal diseases (IFD) has led to high mortality. Currently available antifungal treatments, administered predominantly orally or intravenously, may not sufficiently penetrate certain body sites, and/or are associated with systemic toxicity. Little is known about how to position alternative administration approaches such as inhalational and direct drug delivery routes.

Areas covered: This review provides an updated overview of unconventional drug delivery strategies for managing IFD, focusing on inhalational (to target the lungs) and direct delivery methods to the central nervous system, bone/joint, and eyes. Novel compounds (e.g. opelconazole) and existing antifungals with innovative drug delivery systems currently undergoing clinical trials and/or used off-label in the clinical setting are discussed.

Expert opinion: For both inhalational agents and direct delivery approaches, there are similar challenges that include the absence of: approved formulations for specific administration routes, delivery vehicles that are simple and safe to use whilst maintaining potency and efficiency of delivery, animal models suitable for investigating pharmacokinetic/pharmacodynamic profiles of inhaled antifungals, and consensus on the composite endpoints and intervals for of follow-up in clinical trials. To meet these challenges, cooperation of all stakeholders in drug development and regulation is required.

导言:难以治疗的深部侵袭性真菌病(IFD)发病率不断上升,导致死亡率居高不下。目前可用的抗真菌治疗方法主要通过口服或静脉注射,可能无法充分渗透某些身体部位,和/或与全身毒性有关。人们对如何定位吸入和直接给药途径等替代给药方法知之甚少:本综述对治疗 IFD 的非常规给药策略进行了最新概述,重点关注吸入(针对肺部)和直接给药到中枢神经系统、骨/关节和眼睛的方法。本文讨论了目前正在进行临床试验和/或在临床环境中标签外使用的新型化合物(如奥培康唑)和具有创新给药系统的现有抗真菌药物:对于吸入制剂和直接给药方法来说,都面临着类似的挑战,其中包括:缺乏针对特定给药途径的经批准的制剂;缺乏既简单安全又能保持药效和给药效率的给药载体;缺乏适合研究吸入抗真菌药物的药代动力学/药效学特征的动物模型;以及缺乏对临床试验中综合终点和随访间隔的共识。为了应对这些挑战,需要药物开发和监管方面的所有利益相关者通力合作。
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引用次数: 0
Recent updates in treating carbapenem-resistant infections in patients with hematological malignancies. 治疗血液恶性肿瘤患者耐碳青霉烯类感染的最新进展。
IF 4.2 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-09-29 DOI: 10.1080/14787210.2024.2408746
Abdullah Tarık Aslan, Murat Akova

Introduction: Patients with hematological malignancies (PHMs) are at increased risk for infections caused by carbapenem-resistant organisms (CROs) due to frequent exposure to broad-spectrum antibiotics and prolonged hospital stays. These infections result in high mortality and morbidity rates along with delays in chemotherapy, longer hospitalizations, and increased health care costs.

Areas covered: Treatment alternatives for CRO infections in PHMs.

Expert opinion: The best available treatment option for KPC and OXA-48 producers is ceftazidime/avibactam. Imipenem/cilastatin/relebactam and meropenem/vaborbactam remain as the alternative options. They can also be used as salvage therapy in KPC-positive Enterobacterales infections resistant to ceftazidime/avibactam, if in vitro susceptibility is shown. Treatment of metallo-β-lactamase producers is an unmet need. Ceftazidime/avibactam plus aztreonam or aztreonam/avibactam seems to be the most reliable option for metallo-β-lactamase producers. As a first-line option for carbapenem-resistant Pseudomonas aeruginosa infections, ceftolozane/tazobactam is preferable and ceftazidime/avibactam and imipenem/cilastatin/relebactam constitute alternative regimens. Although sulbactam/durlobactam is the most reliable option against carbapenem-resistant Acinetobacter baumannii infections, its utility as monotherapy and in PHMs is not yet known. Cefiderocol can be selected as a 'last-resort' option for CRO infections. New risk score models supported by artificial intelligence algorithms can be used to predict the exact risk of infections in previously colonized patients.

简介:血液恶性肿瘤(PHMs)患者由于频繁接触广谱抗生素和住院时间延长,感染耐碳青霉烯类病菌(CROs)的风险增加。这些感染导致死亡率和发病率居高不下,同时还会延误化疗、延长住院时间并增加医疗费用:PHM 中 CRO 感染的替代治疗方案:专家观点:针对 KPC 和 OXA-48 生产者的最佳治疗方案是头孢他啶/阿维菌素。亚胺培南/西司他丁/雷巴坦和美罗培南/伐硼内酰胺仍然是替代选择。在对头孢他啶/阿维巴坦耐药的 KPC 阳性肠杆菌感染中,如果体外试验显示对头孢他啶/阿维巴坦敏感,也可将它们用作挽救疗法。金属-β-内酰胺酶产生者的治疗需求尚未得到满足。头孢唑肟/阿维巴坦加阿曲南或阿曲南/阿维巴坦似乎是治疗金属-β-内酰胺酶产生者的最可靠选择。作为耐碳青霉烯类的铜绿假单胞菌感染的一线治疗方案,头孢洛氮烷/他唑巴坦是首选,头孢唑肟/阿维菌素和亚胺培南/西司他丁/雷巴坦是替代方案。虽然舒巴坦/杜洛巴坦是治疗耐碳青霉烯类鲍曼不动杆菌感染的最可靠方案,但其作为单一疗法和在 PHM 中的作用尚不清楚。头孢哌酮可作为 CRO 感染的 "最后选择"。在人工智能算法的支持下,新的风险评分模型可用于预测既往定植患者的确切感染风险。
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引用次数: 0
Ceftolozane/Tazobactam treatment for patients with hospital-acquired and ventilatory-associated bacterial pneumonia in Canada in 2022-2024: results from the CLEAR registry. 2022-2024 年加拿大医院获得性和呼吸机相关细菌性肺炎患者的头孢唑烷/他唑巴坦治疗:CLEAR 登记结果。
IF 4.2 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-09-26 DOI: 10.1080/14787210.2024.2405930
George G Zhanel, Rita Dhami, Melanie Baxter, Maggie Wong, Yazdan Mirzanejad, Justin Kosar, Carlos Cervera, Neal Irfan, Sergio Borgia, Alex Serebryanskyy, Robert Ariano, Michel Savoie, Carlo Tascini, Andrew Walkty, James A Karlowsky

Background: We report results from the national CLEAR (Canadian Leadership on Antimicrobial Real-Life Usage) registry on the usage of ceftolozane/tazobactam in Canada from 2022 to 2024.

Research design and methods: The authors reviewed the final data using the national ethics approved CLEAR study. Thereafter, the literature is surveyed regarding the usage of ceftolozane/tazobactam to treat patients with HABP and VABP via PubMed (up to May 2024).

Results: Ceftolozane/tazobactam was primarily used as directed therapy to treat HABP and VABP caused by Pseudomonas aeruginosa. It was primarily used alone, or in combination with another agent, to treat resistant and multidrug-resistant (MDR) P. aeruginosa infections. Despite primarily being used to treat severely ill patients in intensive care units, its use was associated with relatively high microbiological/clinical cure rates, along with an excellent safety profile. Several reports attest to the microbiological/clinical efficacy and safety of using ceftolozane/tazobactam to treat HABP and VABP.

Conclusions: In Canada, ceftolozane/tazobactam is primarily used as directed therapy alone, or in combination, to treat MDR P. aeruginosa infections. Though mostly used to treat severely ill patients in the ICU, ceftolozane/tazobactam use in HABP and VABP is associated with relatively high microbiological/clinical cure rates and an excellent safety profile.

背景:我们报告了全国性 CLEAR(加拿大抗菌药物真实使用情况领导力)登记的结果,该登记涉及 2022 年至 2024 年期间加拿大头孢唑烷/他唑巴坦的使用情况:作者通过国家伦理批准的 CLEAR 研究审查了最终数据。之后,通过 PubMed 调查了有关使用头孢唑烷/他唑巴坦治疗 HABP 和 VABP 患者的文献(截至 2024 年 5 月):头孢唑烷/他唑巴坦主要用于治疗铜绿假单胞菌引起的HABP和VABP。头孢唑烷/他唑巴坦主要用于治疗由铜绿假单胞菌引起的 HABP 和 VABP,也可单独或与其他药物联合用于治疗耐药和耐多药(MDR)铜绿假单胞菌感染。尽管该药主要用于治疗重症监护室的重症患者,但其微生物/临床治愈率相对较高,且安全性极佳。多份报告证实了使用头孢唑烷/他唑巴坦治疗HABP和VABP的微生物/临床疗效和安全性:在加拿大,头孢妥仑/他唑巴坦主要用于单独或联合治疗MDR铜绿假单胞菌感染。虽然头孢唑烷/他唑巴坦主要用于治疗重症监护室的重症患者,但在HABP和VABP中使用头孢唑烷/他唑巴坦具有相对较高的微生物/临床治愈率和极佳的安全性。
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引用次数: 0
Management of calcified cysticerci in the brain parenchyma: treating the dead parasite. 脑实质内钙化囊尾蚴的治疗:治疗死亡的寄生虫。
IF 4.2 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-09-26 DOI: 10.1080/14787210.2024.2409404
Oscar H Del Brutto

Introduction: Calcifications are the end stage of many parenchymal brain cysticerci and may occur either spontaneously or as the result of treatment with cysticidal drugs. These lesions, traditionally considered inert and asymptomatic, have been associated with several complications that seem to be mostly related to brain damage and inflammation ensuing as the result of the exposure of the host's immune system to parasitic antigens trapped within calcifications.

Areas covered: This review, based on the search of different electronic databases up to May 2024, focuses on the reported correlates and complications of calcified cysticerci (chronic headaches, seizures/epilepsy, hippocampal atrophy/sclerosis, gliomas), and the different interventions developed for their prevention and treatment. Common analgesics, non-steroidal anti-inflammatory drugs, corticosteroids, and antiseizure medications have been used with success but, with the exception of the latter, these drugs offer temporary relief of symptoms and support for their use is based on level 3 evidence.

Expert opinion: Several strategies may reduce the severity of clinical consequences of calcified cysticerci. Probably, the most relevant intervention would be the prevention of their occurrence or reduction in their size. In this view, the use of bisphosphonates appears as a potential option that needs to be tested in humans.

简介钙化是许多脑实质囊尾蚴的终末阶段,可能自发发生,也可能是使用杀囊虫药物治疗的结果。这些病变传统上被认为是惰性和无症状的,但却与多种并发症有关,这些并发症似乎主要与宿主的免疫系统暴露于钙化内的寄生虫抗原而导致的脑损伤和炎症有关:本综述基于截至 2024 年 5 月对不同电子数据库的检索,重点关注已报道的钙化囊尾蚴的相关性和并发症(慢性头痛、癫痫发作、海马体萎缩/硬化、胶质瘤),以及为预防和治疗这些疾病而开发的不同干预措施。常见的镇痛药、非甾体类抗炎药、皮质类固醇激素和抗癫痫药物已被成功使用,但除后者外,这些药物只能暂时缓解症状,对其使用的支持基于三级证据:有几种策略可以减轻钙化囊尾蚴临床后果的严重性。最相关的干预措施可能是预防钙化囊尾蚴的发生或缩小其体积。因此,使用双膦酸盐似乎是一种潜在的选择,需要在人体中进行试验。
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引用次数: 0
Clinical pharmacokinetics of antimicrobials in critical care: a narrative review. 重症监护中抗菌药物的临床药代动力学:叙述性综述。
IF 4.2 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-09-24 DOI: 10.1080/14787210.2024.2406466
Ritika Kondel Bhandari, Rachna Rohilla, Nusrat Shafiq, Avaneesh Kumar Pandey, Samir Malhotra

Introduction: The management of critically ill septic patients presents considerable challenges due to multifaceted physiological alterations. Rapid changes such as fluid shifts, hyperdynamic states, and altered renal clearance often require special attention for better clinical outcomes. Vital organ dysfunction, with or without MODS, often necessitates supportive management like RRT, ventilatory support, and ECMO. These interventions can significantly affect the PK/PD of administered antimicrobials, complicating effective treatment.

Area covered: Patient-specific parameters such as age, weight, and comorbid illnesses (e.g. cystic fibrosis, burns, and immunocompromised states) are critical determinants of antimicrobial pharmacokinetics. Understanding PK/PD determinants is crucial for developing optimized dosing regimens that enhance therapeutic efficacy and minimize toxicity in critically ill patients.

Expert opinion: Incorporating pharmacometrics approaches in dose optimization can significantly improve patient outcomes. This review focuses on the nuances of PK/PD for optimized antimicrobial dosing in critically ill septic patients, emphasizing the importance of individualized treatment plans to address the complex and dynamic needs of this patient population. The adoption of these advanced pharmacokinetic and pharmacodynamic principles into clinical practice is essential for advancing patient care and optimizing therapeutic outcomes in critically ill patients.

导言:脓毒症重症患者由于多方面的生理变化,其管理面临着相当大的挑战。液体转移、高动力状态和肾清除率改变等快速变化往往需要特别关注,以获得更好的临床效果。无论是否出现 MODS,生命器官功能障碍通常都需要支持性治疗,如 RRT、通气支持和 ECMO。这些干预措施会严重影响抗菌药物的 PK/PD,使有效治疗变得复杂:患者特异性参数,如年龄、体重和合并症(如囊性纤维化、烧伤、免疫功能低下等)是抗菌药物药代动力学的关键决定因素。了解 PK/PD 决定因素对于制定优化的给药方案至关重要,这些方案可提高重症患者的疗效并将毒性降至最低:将药物计量学方法纳入剂量优化可显著改善患者预后。这篇综述重点探讨了 PK/PD 在优化脓毒症重症患者抗菌药物剂量方面的细微差别,强调了个体化治疗方案的重要性,以满足这类患者复杂多变的需求。在临床实践中采用这些先进的药代动力学和药效学原理对于促进患者护理和优化重症患者的治疗效果至关重要。
{"title":"Clinical pharmacokinetics of antimicrobials in critical care: a narrative review.","authors":"Ritika Kondel Bhandari, Rachna Rohilla, Nusrat Shafiq, Avaneesh Kumar Pandey, Samir Malhotra","doi":"10.1080/14787210.2024.2406466","DOIUrl":"10.1080/14787210.2024.2406466","url":null,"abstract":"<p><strong>Introduction: </strong>The management of critically ill septic patients presents considerable challenges due to multifaceted physiological alterations. Rapid changes such as fluid shifts, hyperdynamic states, and altered renal clearance often require special attention for better clinical outcomes. Vital organ dysfunction, with or without MODS, often necessitates supportive management like RRT, ventilatory support, and ECMO. These interventions can significantly affect the PK/PD of administered antimicrobials, complicating effective treatment.</p><p><strong>Area covered: </strong>Patient-specific parameters such as age, weight, and comorbid illnesses (e.g. cystic fibrosis, burns, and immunocompromised states) are critical determinants of antimicrobial pharmacokinetics. Understanding PK/PD determinants is crucial for developing optimized dosing regimens that enhance therapeutic efficacy and minimize toxicity in critically ill patients.</p><p><strong>Expert opinion: </strong>Incorporating pharmacometrics approaches in dose optimization can significantly improve patient outcomes. This review focuses on the nuances of PK/PD for optimized antimicrobial dosing in critically ill septic patients, emphasizing the importance of individualized treatment plans to address the complex and dynamic needs of this patient population. The adoption of these advanced pharmacokinetic and pharmacodynamic principles into clinical practice is essential for advancing patient care and optimizing therapeutic outcomes in critically ill patients.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Now that griseofulvin is not available, what to do with tinea capitis treatments? 现在没有了格列齐芬,该如何治疗头癣呢?
IF 4.2 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-09-19 DOI: 10.1080/14787210.2024.2405936
Alexandro Bonifaz, Paola Lumbán-Ramírez, Roxana S García-Sotelo, Helena Vidaurri de la Cruz, Mirna Toledo-Bahena, Adriana Valencia-Herrera

Introduction: Griseofulvin, discovered in 1939 and commercially available since 1959, was the first oral antifungal agent effective against dermatophytosis, particularly tinea capitis. Although it was eventually superseded by azole antifungals due to its long treatment duration and reliance on keratopoiesis, griseofulvin remains notable for its effectiveness and safety in treating tinea capitis, especially when caused by Microsporum canis. However, due to a decline in cases and commercial unavailability, alternative treatments are now required.

Areas covered: The following topics regarding to other treatments were discussed: (I) The efficacy of alternative antifungal agents such as terbinafine, itraconazole, and fluconazole, in the treatment of tinea capitis. (II) The use and role of topical therapies. (III) Experience in the management of tinea capitis.

Expert opinion: The usefulness of oral terbinafine as a replacement for griseofulvin in the treatment of tinea capitis and why it is the preferred drug in elderly patients was discussed. Challenges with Microsporum spp. and the use of fluconazole in pediatric patients were also analyzed. Support for the use of topical treatment as an adjunctive treatment for tinea capitis was highlighted.

简介格列齐芬于 1939 年被发现,1959 年开始在市场上销售,是第一种有效治疗皮肤癣菌病(尤其是头癣)的口服抗真菌药物。虽然由于其疗程长且依赖角化生成,最终被唑类抗真菌药所取代,但格列卫在治疗头癣,尤其是由犬小孢子菌引起的头癣方面的有效性和安全性仍然值得注意。然而,由于病例减少和商业上的不可得性,现在需要替代疗法:讨论了以下有关其他治疗方法的主题:(I)特比萘芬、伊曲康唑和氟康唑等替代抗真菌剂在治疗头癣中的疗效。(II) 局部疗法的使用和作用。(专家意见:讨论了口服特比萘芬替代格列齐芬治疗头癣的作用,以及为什么口服特比萘芬是老年患者的首选药物。还分析了小孢子菌属所面临的挑战以及氟康唑在儿童患者中的应用。会议还强调了支持使用局部治疗作为头癣的辅助治疗方法。
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引用次数: 0
Novel agents in development for the treatment of resistant Gram-negative infections. 正在开发用于治疗耐药性革兰氏阴性菌感染的新型制剂。
IF 5.7 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-09-18 DOI: 10.1080/14787210.2024.2407068
Matteo Bassetti,Barbara Larosa,Antonio Vena,Daniele Roberto Giacobbe
INTRODUCTIONSeveral novel agents are in advanced stages of clinical development, potentially expanding our treatment options against third- and fourth-generation cephalosporin-resistant and carbapenem-resistant Gram-negative bacteria (GNB), including those pathogens for which the current number of effective treatments is limited.AREAS COVEREDThis review focuses on agents that have completed or ongoing phase-3 studies. A PubMed search was conducted up to 31 May 2024.EXPERT OPINIONNovel agents in late-stage clinical development belong to the β-lactam or β-lactam/β-lactamase inhibitor combinations class and display variable antimicrobial activity depending on the specific β-lactamases expressed by GNB, particularly carbapenemases. While many of these novel agents demonstrate in vitro activity against carbapenem-resistant GNB, their efficacy has mainly been evaluated in phase-3 randomized controlled trials (RCT) for infections caused by carbapenem-susceptible GNB. Although evidence from real-world observational studies is generally less robust than that from RCT, it could be crucial for updating clinical guidelines on treating carbapenem-resistant GNB with these new agents in the absence of dedicated RCT.
简介几种新型制剂正处于临床开发的后期阶段,有可能扩大我们对第三代和第四代头孢菌素耐药和碳青霉烯耐药革兰氏阴性菌(GNB)的治疗选择,包括那些目前有效治疗方法数量有限的病原体。专家观点处于后期临床开发阶段的新型药物属于β-内酰胺或β-内酰胺/β-内酰胺酶抑制剂组合类,根据 GNB 表达的特定β-内酰胺酶(尤其是碳青霉烯酶)的不同而显示出不同的抗菌活性。虽然这些新型制剂中的许多对耐碳青霉烯类的 GNB 具有体外活性,但其疗效主要是在第三阶段随机对照试验(RCT)中对由碳青霉烯类易感 GNB 引起的感染进行评估的。虽然真实世界观察性研究的证据通常不如随机对照试验的证据有力,但在没有专门的随机对照试验的情况下,这些证据对于更新使用这些新药治疗耐碳青霉烯类 GNB 的临床指南至关重要。
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引用次数: 0
Diagnosing fungal infections in clinical practice: a narrative review. 临床实践中的真菌感染诊断:综述。
IF 5.7 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-09-13 DOI: 10.1080/14787210.2024.2403017
Sarah Sedik,Stella Wolfgruber,Martin Hoenigl,Lisa Kriegl
BACKGROUNDInvasive fungal infections (IFI) present a major medical challenge, with an estimated 6.5 million cases annually, resulting in 3.8 million deaths. Pathogens such as Aspergillus spp. Candida spp. Mucorales spp. Cryptococcus spp. and other fungi species contribute to these infections, posing risks to immunocompromised individuals. Early and accurate diagnosis is crucial for effective treatment and better patient outcomes.AREAS COVEREDThis narrative review provides an overview of the current methods and challenges associated with diagnosing fungal diseases including invasive aspergillosis, invasive candidiasis as well as rare and endemic fungal infections. Various diagnostic techniques, including microscopy, culture, molecular diagnostics, and serological tests, are reviewed, highlighting their respective advantages and limitations and role in clinical guidelines. To illustrate, the need for improved diagnostic strategies to overcome existing challenges, such as the low sensitivity and specificity of current tests and the time-consuming nature of traditional culture-based methods, is addressed.EXPERT OPINIONCurrent advancements in fungal infection diagnostics have significant implications for healthcare outcomes. Improved strategies like molecular testing and antigen detection promise early detection of fungal pathogens, enhancing patient management. Challenges include global access to advanced technologies and the need for standardized, user-friendly point-of-care diagnostics to improve diagnosis of fungal infections globally.
背景侵袭性真菌感染(IFI)是一项重大的医学挑战,估计每年有 650 万病例,导致 380 万人死亡。曲霉菌属、念珠菌属、粘菌属、隐球菌属等病原体和其他真菌物种是造成这些感染的原因,对免疫力低下的人构成风险。本综述概述了当前诊断真菌性疾病(包括侵袭性曲霉菌病、侵袭性念珠菌病以及罕见和地方性真菌感染)的方法和挑战。文章回顾了各种诊断技术,包括显微镜检查、培养、分子诊断和血清学检测,强调了它们各自的优势和局限性以及在临床指南中的作用。专家观点当前真菌感染诊断技术的进步对医疗成果具有重大影响。分子检测和抗原检测等改进策略有望及早发现真菌病原体,从而加强对患者的管理。面临的挑战包括全球范围内先进技术的普及,以及需要标准化、用户友好的护理点诊断方法来改善全球真菌感染的诊断。
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引用次数: 0
Immunomodulatory markers and therapies for the management of infant respiratory syncytial virus infection 治疗婴儿呼吸道合胞病毒感染的免疫调节标记物和疗法
IF 5.7 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-09-13 DOI: 10.1080/14787210.2024.2403147
Ricardo A. Loaiza, Mónica A. Farías, Catalina A. Andrade, Mario A. Ramírez, Linmar Rodriguez-Guilarte, José T. Muñóz, Pablo A. González, Susan M. Bueno, Alexis M. Kalergis
The human respiratory syncytial virus (hRSV) is one of childhood diseases’ most common respiratory pathogens and is highly associated with lower respiratory tract infections. The dramatic peak in d...
人类呼吸道合胞病毒(hRSV)是儿童疾病中最常见的呼吸道病原体之一,与下呼吸道感染密切相关。人类呼吸道合胞病毒(hRSV)是儿童疾病中最常见的呼吸道病原体之一,与下呼吸道感染高度相关。
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引用次数: 0
Anti-infective therapies for Pythium insidiosum keratitis. 脓疱疮性角膜炎的抗感染疗法。
IF 5.7 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-09-13 DOI: 10.1080/14787210.2024.2403146
Bharat Gurnani,Kirandeep Kaur
INTRODUCTIONPythium insidiosum keratitis (PIK) is a rapidly progressing ocular disease predominantly found in tropical and subtropical regions. Characterized by severe corneal damage and high morbidity, this infection poses significant challenges in diagnosis and management, necessitating effective anti-infective therapies.AREAS COVEREDThis report delves into the pathophysiology, clinical and microbiological diagnosis, and detailed insights into the anti-infective therapy for PIK, outlining current diagnostic challenges that complicate treatment. We review existing anti-infective therapies, including their efficacy and limitations, and discuss the role of surgical interventions in managing advanced cases. The report also highlights ongoing research into novel treatment approaches and the critical need for developing targeted therapies.EXPERT OPINIONDespite advances in understanding PIK, treatment remains complex due to pathogen resistance and diagnostic hurdles. Future research should focus on innovative anti-infective strategies, improved diagnostic techniques, and global surveillance to enhance therapeutic outcomes. Collaboration between ophthalmologists, microbiologists, and pharmacologists is essential to advance treatment protocols and improve patient prognosis.
简介角膜内脓疱病(PIK)是一种进展迅速的眼部疾病,主要发生在热带和亚热带地区。本报告深入探讨了病理生理学、临床和微生物学诊断,并详细介绍了 PIK 的抗感染治疗方法,概述了当前使治疗复杂化的诊断难题。我们回顾了现有的抗感染疗法,包括其疗效和局限性,并讨论了外科干预在治疗晚期病例中的作用。本报告还强调了正在进行的新型治疗方法研究,以及开发靶向疗法的迫切需要。专家观点尽管对 PIK 的认识取得了进展,但由于病原体耐药性和诊断障碍,治疗仍然很复杂。未来的研究应侧重于创新抗感染策略、改进诊断技术和全球监测,以提高治疗效果。眼科医生、微生物学家和药理学家之间的合作对于推进治疗方案和改善患者预后至关重要。
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引用次数: 0
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Expert Review of Anti-infective Therapy
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