侵袭性真菌病(IFD)仍然是发病和死亡的重要原因。欧洲癌症研究和治疗组织传染病小组和真菌病研究小组的共识定义对进行抗真菌药物临床试验的研究人员具有巨大价值,评估诊断测试,并进行流行病学研究。然而,它们的效用尚未扩展到癌症患者或干细胞或实体器官移植的接受者。有了更新的诊断技术,很明显,更新这些定义是必不可少的。
要做到这一点,10个工作组密切关注成像,实验室诊断,和面临IFD风险的特殊人群。在小组的研究结果在科学研讨会上发表并经过3个月的公众意见征询后,手稿的最终版本得到了同意。在手稿的最终版本获得批准之前,进行了几轮讨论。
“已证明”的分类没有变化,\"\"很可能,\"和\"可能\"IFD,虽然“可能”的定义已经扩大,“可能”类别的范围已经缩小。经过验证的IFD类别可以适用于任何患者,无论患者是否免疫功能低下。仅针对免疫功能低下的患者提出了可能和可能的类别,除了地方性真菌病.
这些更新的IFD定义应证明适用于临床,诊断,和更广泛的高危患者的流行病学研究。
Invasive fungal diseases (IFDs) remain important causes of morbidity and mortality. The
consensus definitions of the Infectious Diseases Group of the European Organization for Research and Treatment of Cancer and the Mycoses Study Group have been of immense value to researchers who conduct clinical trials of antifungals, assess diagnostic tests, and undertake epidemiologic studies. However, their utility has not extended beyond patients with cancer or recipients of stem cell or solid organ transplants. With newer diagnostic techniques available, it was clear that an update of these definitions was essential.
To achieve this, 10 working groups looked closely at imaging, laboratory diagnosis, and special populations at risk of IFD. A final version of the manuscript was agreed upon after the groups\' findings were presented at a scientific symposium and after a 3-month period for public comment. There were several rounds of discussion before a final version of the manuscript was approved.
There is no change in the classifications of \"proven,\" \"probable,\" and \"possible\" IFD, although the definition of \"probable\" has been expanded and the scope of the category \"possible\" has been diminished. The category of proven IFD can apply to any patient, regardless of whether the patient is immunocompromised. The probable and possible categories are proposed for immunocompromised patients only, except for endemic mycoses.
These updated definitions of IFDs should prove applicable in clinical, diagnostic, and epidemiologic research of a broader range of patients at high-risk.