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Abstract：
With increasing numbers of patients needing intensive care or who are immunosuppressed, infections caused by moulds other than Aspergillus spp or Mucorales are increasing. Although antifungal prophylaxis has shown effectiveness in preventing many invasive fungal infections, selective pressure has caused an increase of breakthrough infections caused by Fusarium, Lomentospora, and Scedosporium species, as well as by dematiaceous moulds, Rasamsonia, Schizophyllum, Scopulariopsis, Paecilomyces, Penicillium, Talaromyces and Purpureocillium species. Guidance on the complex multidisciplinary management of infections caused by these pathogens has the potential to improve prognosis. Management routes depend on the availability of diagnostic and therapeutic options. The present recommendations are part of the One World-One Guideline initiative to incorporate regional differences in the epidemiology and management of rare mould infections. Experts from 24 countries contributed their knowledge and analysed published evidence on the diagnosis and treatment of rare mould infections. This consensus document intends to provide practical guidance in clinical decision making by engaging physicians and scientists involved in various aspects of clinical management. Moreover, we identify areas of uncertainty and constraints in optimising this management.
摘要：
随着越来越多的患者需要重症监护或免疫抑制，由曲霉属或毛霉以外的霉菌引起的感染正在增加。尽管抗真菌预防已显示出预防许多侵袭性真菌感染的有效性，选择性压力导致镰刀菌引起的突破性感染增加，Lomentospora,和Scedosporium物种，以及持久的霉菌，Rasamsonia,Schizophyllum,龙须菜,拟青霉,青霉,Talaromyces和Purpureocillium物种。对这些病原体引起的感染进行复杂的多学科管理的指导具有改善预后的潜力。管理途径取决于诊断和治疗选择的可用性。本建议是“一个世界一个准则”倡议的一部分，该倡议将地区差异纳入罕见霉菌感染的流行病学和管理。来自24个国家的专家贡献了他们的知识，并分析了有关罕见霉菌感染的诊断和治疗的已发表证据。该共识文件旨在通过参与临床管理各个方面的医生和科学家，为临床决策提供实用指导。此外，我们确定了优化这种管理的不确定性和制约因素。
