优化对Candida感染的抗真菌疗法:证据,耐药性和新兴方法
Catriona Halliday1, Laura Alguacil-Cuéllar2, Sharon C-A Chen1
1Centre for Infectious Diseases and Microbiology Laboratory Services, New South Wales Health Pathology, Westmead Hospital, Sydney, New South Wales, Australia; Department of Infectious Diseases, Westmead Hospital, School of Medicine, University of Sydney, Sydney, New South Wales, Australia.
概括
在Candida物种中抗真菌耐药性是一个日益增长的威胁,需要新的治疗方法. 本综述探讨了耐药性机制和有前途的新疗法,如组合治疗和新抗真菌剂,以对抗侵入性真菌感染.
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Candida感染对全球健康构成重大挑战,尤其对免疫功能低下的人来说.
- 增加Candida物种的抗真菌耐药性,特别是非白菌株,限制了治疗选择,增加了死亡率.
- 抵抗的机制包括排泄过度表达,向突变,生物膜形成和适应性应激反应.
研究的目的:
- 审查Candida物种抗真菌耐药性的主要机制.
- 探索新兴的治疗策略,包括组合疗法和新型抗真菌剂,用于治疗Candida感染.
主要方法:
- 对同行评审的文献,临床指南和最近的研究进行了全面的审查.
- 对Candida的抗真菌耐药机制的证据分析.
- 对新型抗真菌药物和组合治疗策略的当前数据的评估.
主要成果:
- 坎迪达耐药性源于排泄,目标突变,生物膜,表型转换和基因组可塑性.
- 新兴疗法包括新型药物,如rezafungin,ibrexafungerp和fosmanogepix.
- 针对抗药性途径的组合疗法也在研究中.
结论:
- 解决抗真菌耐药性需要优化疗法和改进的诊断.
- 新型抗真菌药物和组合疗法有希望,但需要进一步的临床验证.
- 加强抗真菌管理和耐药性监测对于管理坎迪达菌感染和减轻公共卫生风险至关重要.
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