侵袭性深部真菌病的实验室诊断 倪语星ppt课件.pptVIP

侵袭性深部真菌病的实验室诊断;侵袭性真菌病的致病菌;;高危人群+高危因素=IFD;IFD的高危人群和高危因素;;尸体解剖中侵袭性真菌感染的发生率;54.84%;侵袭性真菌病的流行病学特点 危险因素不断增多，发生率逐年增高趋势，确切资料有待收集整理 白念珠菌仍然是最常见临床分离致病菌 非白念珠菌增加（带来的问题） 曲霉已成为重要的致死真菌;真菌感染的实验诊断方法及问题;真菌抗原、细胞壁成分检测;新生隐球菌乳胶凝集试验;血清GM作为诊断的早期标志物;在BAL中检测GM作为早期诊断标志;关于GM试验与G试验;Prospective utility of (1-3)-B-D-Glucan (BG), galactomannan (GM) and anti-Candida albicans germ tube antibodies (CAGT) for the diagnosis of invasive fungal disease (IFD) in haemato-oncology adult patients A. Alhambra1, M.S. Cuétara2, J.M. Moreno1, A. Del Palcio Perez-Medel1, I. Moragues3, J. Pontón3, A. Del Palacio1 1Hospital Universitario Doce de Octubre, MADRID, Spain 2Hospital Universitario Severo Ochoa, LEGANES, Spain 3Universidad del Pais Vasco, BILBAO, Spain;Invasive Candidiasis S SP PPV NPV CAGT (%) 57 93 44 96 BG (%) 77 86 39 97 Invasive Aspergillosis S SP PPV NPV GM (%) 92 94 73 98 BG (%) 57 84 42 91;CONCLUSIONS ? The incidence of IFD correlated directly and significantly (x2 p=0.0005) with risk stratification group: highest proportion in the high-risk group. ?Since all the biomarkers have inherent limitations, a better diagnosis yield is achieved combining the biomarkers. ? All three biomarkers share high negative predictive value and can exclude reasonably IFD in haematology adult patients treated with wide spectrum antifungals.;Evaluation of two serologic test for diagnosis invasive Aspergillosis C. Castro, A. Romero, A. Aller, T. Gonzalez, A. González, E. Martín-Mazuelos H. U. Valme, SEVILLA, Spain;A total of 236 sera from 51 patients in risk of IA were tested for GM using Platelia Aspergillus kit (Bio Rad, France) which 36 sera (10 patients) were tested for BG also using Fungitell kit (Associates of Cape Cod., USA). Patients were attended at the University Hospital of Valme from Seville from January of 2008 to December 2008. Patients with GM index ≥0.5 in two consecutive samples have been marked as GM