组织胞浆菌病,主要在非洲流行的一种重要的真菌病,北美和南美,随着全球新出现的报告,带来了显著的健康挑战,特别是免疫功能低下的个体,如艾滋病毒/艾滋病患者和器官移植受者。本系统综述,旨在通知世界卫生组织的真菌优先病原体清单,使用PubMed和WebofScience批判性地审查2011年至2021年的文献,专注于发病率,死亡率,发病率,抗真菌耐药性,可预防性,和组织胞浆的分布。我们还发现艾滋病毒感染者的患病率很高(22%-44%),死亡率从21%到53%不等。尽管数据有限,组织胞浆菌病的患病率似乎稳定,欧洲的估计较低。并发症如中枢神经系统疾病,肺部问题,并注意到由于肉芽肿或硬化引起的淋巴水肿,尽管他们的负担仍然不确定。抗真菌药物敏感性各不相同,特别是对氟康唑(MIC:≥32mg/l)和卡泊芬净(MIC:4-32mg/l),而对两性霉素B的抗性(MIC:0.125-0.16mg/l),伊曲康唑(MIC:0.004-0.125mg/l),伏立康唑(MIC:0.004-0.125mg/l)仍然很低。这篇综述确定了关键的知识差距,强调了对健壮的需求,具有全球代表性的监测系统,以更好地了解和打击这种真菌威胁。
Histoplasmosis, a significant mycosis primarily prevalent in Africa, North and South America, with emerging reports globally, poses notable health challenges, particularly in immunocompromised individuals such as people living with HIV/AIDS and organ transplant recipients. This systematic
review, aimed at informing the World Health Organization\'s Fungal Priority Pathogens List, critically examines literature from 2011 to 2021 using PubMed and Web of Science, focusing on the incidence, mortality, morbidity, antifungal resistance, preventability, and distribution of Histoplasma. We also found a high prevalence (22%-44%) in people living with HIV, with mortality rates ranging from 21% to 53%. Despite limited data, the prevalence of histoplasmosis seems stable, with lower estimates in Europe. Complications such as central nervous system disease, pulmonary issues, and lymphoedema due to granuloma or sclerosis are noted, though their burden remains uncertain. Antifungal susceptibility varies, particularly against fluconazole (MIC: ≥32 mg/l) and caspofungin (MICs: 4-32 mg/l), while resistance to amphotericin B (MIC: 0.125-0.16 mg/l), itraconazole (MICs: 0.004-0.125 mg/l), and voriconazole (MICs: 0.004-0.125 mg/l) remains low. This
review identifies critical knowledge gaps, underlining the need for robust, globally representative surveillance systems to better understand and combat this fungal threat.