课件：侵袭性真菌感染诊治进展吕晓菊.ppt

避免临床诊治失败的关键因素 早期诊断 早期治疗 足剂量 足疗程 THANK YOU SUCCESS * * 可编辑 * The immunogenic properties of fungal organisms have been exploited in tests for the presence of both fungal antigen and antibody in biologic fluids. The diagnostic value of tests for antigen or antibody reactions is highly dependent on the organism. Numerous methodologies have been used or are being developed with varying degrees of sensitivity and specificity. These include counter-immunoelectrophoresis, radioimmunoassay, latex agglutination, immunoblot, and enzyme-linked immunoassay (ELISA). Reliable tests are available for accurately diagnosing endemic infections such as coccidioidomycosis and histoplasmosis; similar successes have not been achieved with invasive aspergillosis and candidiasis. Biochemical assays for circulating metabolic products such as mannose and D-arabinitol using gas-liquid chromatography have been described, although none are in regular use in the clinical laboratory. The galactomannan assay for aspergillosis may prove useful in the future. DNA fingerprinting and polymerase chain reaction (PCR) techniques are areas under development. * Culture provides a definitive diagnosis of a fungal infection but has several limitations. Isolation and identification can take several weeks, and results may be too late to guide treatment. Traditional blood-culture methods are relatively insensitive. Automated methods (biphasic media, lysis centrifugation, BacT/Alert BACTEC) give early detection of growth but are more expensive. (BSIs, bloodstream infections) * The immunogenic properties of fungal organisms have been exploited in tests for the presence of both fungal antigen and antibody in biologic fluids. The diagnostic value of tests for antigen or antibody reactions is highly dependent on the organism. Numerous methodologies have been used or are being developed with varying degrees of sensitivity and specificity. These include counter-immunoelectrophoresis, radioimmunoassay, latex ag