不常见,或罕见,由于免疫功能低下或严重疾病的患者数量不断增加,酵母菌感染正在上升。主要病原体包括地霉属,萨普罗查特,Magnusiomyces,和Trichosporon(即,担子菌)和Kodamaea,马拉色菌,假子(即,现在是Moesziomyces或Dirkmeia),红霉素,酵母菌,和孢子菌属(即,子囊菌)。一种经过深思熟虑的方法,由这些病原体引起的感染的多学科管理对于优化患者预后至关重要;然而,管理准则要么针对特定地区,要么需要更新。根据纳入区域差异的“一个世界-一个准则”倡议,来自不同地理区域的专家分析了描述先前提到的稀有酵母的流行病学和管理的出版物。本指南总结了关于这些罕见酵母菌感染患者的诊断和治疗选择的共识建议。目的是为临床决策提供实际帮助。因为罕见酵母菌感染患者的临床经验较少,而且对这些患者的研究不是随机的,也没有比较群体,大多数建议在验证方面并不稳健,但通过使用专家意见和体外药敏结果来表达见解.在这篇评论中,我们报告了流行病学的主要特征,诊断,抗真菌药敏,以及Geotrichum患者的治疗结果,萨普罗查特,Magnusiomyces,和Trichosporon感染。
Uncommon, or rare, yeast infections are on the rise given increasing numbers of patients who are immunocompromised or seriously ill. The major pathogens include those of the genera Geotrichum, Saprochaete, Magnusiomyces, and Trichosporon (ie, basidiomycetes) and Kodamaea, Malassezia, Pseudozyma (ie, now Moesziomyces or Dirkmeia), Rhodotorula, Saccharomyces, and Sporobolomyces (ie, ascomycetes). A considered approach to the complex, multidisciplinary management of infections that are caused by these pathogens is essential to optimising patient outcomes; however, management
guidelines are either region-specific or require updating. In alignment with the One World-One
Guideline initiative to incorporate regional differences, experts from diverse geographical regions analysed publications describing the epidemiology and management of the previously mentioned rare yeasts. This
guideline summarises the
consensus recommendations with regards to the diagnostic and therapeutic options for patients with these rare yeast infections, with the intent of providing practical assistance in clinical decision making. Because there is less clinical experience of patients with rare yeast infections and studies on these patients were not randomised, nor were groups compared, most recommendations are not robust in their validation but represent insights by use of expert opinions and in-vitro susceptibility results. In this Review, we report the key features of the epidemiology, diagnosis, antifungal susceptibility, and treatment outcomes of patients with Geotrichum, Saprochaete, Magnusiomyces, and Trichosporon spp infections.