在 COVID-19 的背景下进行粘孢子虫病快速抗原检测的潜力。

IF 3.9 3区 医学 Q1 PATHOLOGY Expert Review of Molecular Diagnostics Pub Date : 2024-03-01 Epub Date: 2023-07-07 DOI:10.1080/14737159.2023.2233906
Christopher R Thornton
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引用次数: 0

摘要

简介粘孢子菌病是由粘孢子菌引起的一种侵袭性很强的血管侵袭性疾病。在 COVID-19 大流行之前,粘孢子菌病是一种罕见的真菌病,通常见于免疫力低下的血液恶性肿瘤患者或移植受者。在第二波大流行期间,这种疾病急剧增加,尤其是在印度,那里的一系列特殊情况导致了大量危及生命和毁容的鼻-眶-脑粘孢子菌病(ROCM)感染:综述探讨了作为 COVID-19 患者超级感染的粘孢子菌病,以及导致印度 ROCM 流行的 COVID-19 相关粘孢子菌病 (CAM) 的风险因素。确定了当前诊断程序的局限性,并讨论了提高检测速度和准确性所需的措施:专家观点:尽管人们对该疾病的认识有所提高,但全球医疗保健系统仍未做好应对 ROCM 进一步爆发的准备。目前对该疾病的诊断既缓慢又不准确,对患者的生存造成了负面影响。这种情况在中低收入国家最为明显,这些国家缺乏设备齐全的诊断设施,无法快速识别感染病原体。使用护理点侧向流检测法进行快速抗原检测可能有助于快速、准确地诊断该疾病,从而可以更早地进行手术和使用黏菌类抗真菌药物。
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The potential for rapid antigen testing for mucormycosis in the context of COVID-19.

Introduction: Mucormycosis is a highly aggressive angio-invasive disease of humans caused by Mucorales fungi. Prior to the COVID-19 pandemic, mucormycosis was a rare mycosis typically seen in immunocompromised patients with hematological malignancies or in transplant recipients. During the second wave of the pandemic, there was a dramatic increase in the disease, especially in India where a unique set of circumstances led to large numbers of life-threatening and disfiguring rhino-orbital-cerebral mucormycosis (ROCM) infections.

Areas covered: The review examines mucormycosis as a super-infection of COVID-19 patients, and the risk factors for COVID-19-associated mucormycosis (CAM) that drove the ROCM epidemic in India. The limitations of current diagnostic procedures are identified, and the measures needed to improve the speed and accuracy of detection discussed.

Expert opinion: Despite increased awareness, global healthcare systems remain unprepared for further outbreaks of ROCM. Current diagnosis of the disease is slow and inaccurate, negatively impacting on patient survival. This is most evident in low- to middle-income countries which lack suitably equipped diagnostic facilities for rapid identification of the infecting pathogens. Rapid antigen testing using point-of-care lateral-flow assays could potentially have aided in the quick and accurate diagnosis of the disease, allowing earlier intervention with surgery and Mucorales-active antifungal drugs.

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来源期刊
CiteScore
6.60
自引率
0.00%
发文量
71
审稿时长
1 months
期刊介绍: Expert Review of Molecular Diagnostics (ISSN 1473-7159) publishes expert reviews of the latest advancements in the field of molecular diagnostics including the detection and monitoring of the molecular causes of disease that are being translated into groundbreaking diagnostic and prognostic technologies to be used in the clinical diagnostic setting. Each issue of Expert Review of Molecular Diagnostics contains leading reviews on current and emerging topics relating to molecular diagnostics, subject to a rigorous peer review process; editorials discussing contentious issues in the field; diagnostic profiles featuring independent, expert evaluations of diagnostic tests; meeting reports of recent molecular diagnostics conferences and key paper evaluations featuring assessments of significant, recently published articles from specialists in molecular diagnostic therapy. Expert Review of Molecular Diagnostics provides the forum for reporting the critical advances being made in this ever-expanding field, as well as the major challenges ahead in their clinical implementation. The journal delivers this information in concise, at-a-glance article formats: invaluable to a time-constrained community.
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