针对成年人侵入性真菌感染的治疗方法的最新情况
Catherine-Audrey Boutin1, Me-Linh Luong2
1Division of Infectious Diseases, Department of Medicine, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada.
Therapeutic advances in infectious disease
|January 22, 2024
概括
本综述总结了当前和新兴的针对免疫受损成人侵入性真菌感染的治疗方法,解决了药物耐药性和延迟诊断等挑战,以获得更好的患者结果.
科学领域:
- 医学真菌学 医学真菌学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 侵入性真菌感染 (IFI) 正在增加,原因是移植受体,癌症患者和接受像布鲁顿氨酸激酶 (BTK) 抑制剂等免疫调节疗法的人群中,亚原性免疫抑制增加.
- 由于模具和酵母中出现的耐药性,IFI的死亡率增加,使治疗决策复杂化.
- 抗真菌敏感性测试的延迟需要基于宿主因素,临床表现和局部耐药性模式的经验和定制疗法.
研究的目的:
- 审查和综合当前的建议和关于治疗成年人侵入性菌和酵母菌感染的最新文献.
- 以指导IFI的基于证据的治疗策略,考虑宿主因素和新出现的耐药性.
- 突出挑战并探索复杂病例的新型抗真菌剂和治疗方式.
主要方法:
- 对现有指导方针的综合文献综述和关于IFI的抗真菌治疗的最新研究.
- 分析支持当前抗真菌剂的数据,包括三醇和它们的比较.
- 讨论新兴真菌和新型治疗剂引起的感染的管理策略.
主要成果:
- 综述综合了包括三醇在内的既定和新兴抗真菌剂的数据.
- 讨论了由Scedosporium spp.,Fusarium spp.,Trichosporon asahii和Candida auris引起的具有挑战性的感染的管理.
- 包括探索较新的药物,如Olorofim,Rezafungin,Fosmanogepix和内化安福特里辛B.
结论:
- 最佳的IFI治疗需要考虑宿主免疫抑制,先前暴露和局部耐药性数据.
- 新兴的真菌和抗真菌耐药性带来了重大的治疗挑战.
- 进一步研究和开发新型抗真菌剂和治疗策略对于改善免疫受损患者的治疗结果至关重要.
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