背景:真菌感染在免疫功能低下和免疫功能正常的患者中的发病率和重要性日益增加。及时的诊断依赖于在易感患者中适当使用实验室测试。方法:查阅与侵袭性肺曲霉病诊断相关的相关文献,侵袭性念珠菌病,系统回顾了常见的地方性真菌病。适当时进行Meta分析。建议是使用建议等级评估制定的,发展,和评价方法。结果:本指南包括关于在血清和BAL中使用半乳甘露聚糖检测以及诊断侵袭性肺曲霉病的具体建议,PCR在侵袭性肺曲霉病诊断中的作用,β-d-葡聚糖测定在侵袭性念珠菌病诊断中的作用,以及血清学和抗原检测在地方性真菌病诊断中的应用。结论:快速,真菌感染的准确诊断依赖于实验室检测的适当应用,包括抗原检测,血清学检测,和基于PCR的检测。
Background: Fungal infections are of increasing incidence and importance in immunocompromised and immunocompetent patients. Timely diagnosis relies on appropriate use of laboratory testing in susceptible patients.Methods: The relevant literature related to diagnosis of invasive pulmonary aspergillosis, invasive candidiasis, and the common endemic mycoses was systematically reviewed. Meta-analysis was performed when appropriate. Recommendations were developed using the Grading of Recommendations Assessment, Development, and Evaluation approach.Results: This
guideline includes specific recommendations on the use of galactomannan testing in serum and BAL and for the diagnosis of invasive pulmonary aspergillosis, the role of PCR in the diagnosis of invasive pulmonary aspergillosis, the role of β-d-glucan assays in the diagnosis of invasive candidiasis, and the application of serology and antigen testing in the diagnosis of the endemic mycoses.Conclusions: Rapid, accurate diagnosis of fungal infections relies on appropriate application of laboratory testing, including antigen testing, serological testing, and PCR-based assays.