入侵性霉菌感染的非培养基诊断测试取得进展。

IF 3.6 3区 医学 Q2 INFECTIOUS DISEASES Current Opinion in Infectious Diseases Pub Date : 2024-09-16 DOI:10.1097/qco.0000000000001060
P Lewis White
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引用次数: 0

摘要

本综述介绍了使用非常规诊断方法诊断侵袭性霉菌病和肺孢子菌肺炎的现状。用于诊断曲霉菌病的侧流试验(LFTs)补充了半乳甘露聚糖酶联免疫吸附试验(galactomannan ELISA),用于其他真菌疾病的侧流试验也在开发之中。快速、低通量的 B-D 葡聚糖检测增加了检测的可及性,分子检测的标准化/开发也取得了重大进展。尽管如此,目前还没有一种完美的检测方法,要对大多数真菌病进行最佳诊断,可能需要结合多种检测方法(如抗原检测和分子检测)。摘要根据已确定的临床表现,很少有真菌学检测方法可单独用于真菌病(FD)的最佳诊断,包括传统方法在内的多种检测方法是确诊和排除疾病的首选途径。下一代测序可能会在我们诊断疾病的过程中发挥越来越大的作用,但整个分子过程需要优化、标准化和验证,我们必须考虑宿主生物标志物如何对风险进行分层。鉴于 FD 给中低收入国家造成的负担,改善新型诊断检测的可及性以及简化检测流程至关重要。
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Progress on nonculture based diagnostic tests for invasive mould infection.
PURPOSE OF REVIEW This review describes the current status of diagnosing invasive mould disease and Pneumocystis pneumonia using nonconventional diagnostics methods. RECENT FINDINGS There has been significant development in the range of nonculture mycological tests. Lateral flow tests (LFTs) for diagnosing aspergillosis complement galactomannan ELISA testing, and LFTs for other fungal diseases are in development. Rapid and low through-put B-D-Glucan assays increase access to testing and there has been significant progress in the standardization/development of molecular tests. Despite this, no single perfect test exists and combining tests (e.g., antigen and molecular testing) is likely required for the optimal diagnosis of most fungal diseases. SUMMARY Based on established clinical performance few mycological tests can be used alone for optimal diagnosis of fungal disease (FD) and combining tests, including classical approaches is the preferred route for confirming and excluding disease. Next-generation sequencing will likely play an increasing role in how we diagnose disease, but optimization, standardization and validation of the entire molecular process is needed and we must consider how host biomarkers can stratify risk. Given the burden of FD in low- and medium-income countries, improved access to novel but more so existing diagnostic testing is critical along with simplification of testing processes.
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来源期刊
CiteScore
6.70
自引率
2.60%
发文量
121
审稿时长
6-12 weeks
期刊介绍: This reader-friendly, bimonthly resource provides a powerful, broad-based perspective on the most important advances from throughout the world literature. Featuring renowned guest editors and focusing exclusively on two topics, every issue of Current Opinion in Infectious Disease delivers unvarnished, expert assessments of developments from the previous year. Insightful editorials and on-the-mark invited reviews cover key subjects such as HIV infection and AIDS; skin and soft tissue infections; respiratory infections; paediatric and neonatal infections; gastrointestinal infections; tropical and travel-associated diseases; and antimicrobial agents.
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