COVID-19.рф: ИНФОРМАЦИЯ ПРОТИВ ПАНДЕМИИ

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Diagnosis and management of Aspergillus diseases: executive summary of the 2017 ESCMID-ECMM-ERS guideline

A. Ullmann, J. Aguado, S. Arikan-Akdagli, D. Denning, A. Groll, K. Lagrou, C. Lass-Flörl, R. Lewis, P. Munoz, P. Verweij, A. Warris, F. Ader, M. Akova, M. Arendrup, R. Barnes, C. Beigelman-Aubry, S. Blot, E. Bouza, R. Brüggemann, D. Buchheidt, J. Cadranel, E. Castagnola, A. Chakrabarti, M. Cuenca-Estrella, G. Dimopoulos, J. Fortun, J. Gangneux, J. Garbino, W. Heinz, R. Herbrecht, C. Heussel, C. Kibbler, N. Klimko, B. Kullberg, C. Lange, T. Lehrnbecher, J. Löffler, O. Lortholary, J. Maertens, O. Marchetti, J. Meis, L. Pagano, P. Ribaud, M. Richardson, E. Roilides, M. Ruhnke, M. Sanguinetti, D. Sheppard, J. Sinkó, A. Skiada, M. Vehreschild, C. Viscoli, O. Cornely,
2021
https://doi.org/10.1016/j.cmi.2018.01.002

The European Society for Clinical Microbiology and Infectious Diseases, the European Confederation of Medical Mycology and the European Respiratory Society Joint Clinical Guidelines focus on diagnosis and management of aspergillosis. Of the numerous recommendations, a few are summarized here. Chest computed tomography as well as bronchoscopy with bronchoalveolar lavage (BAL) in patients with suspicion of pulmonary invasive aspergillosis (IA) are strongly recommended. For diagnosis, direct microscopy, preferably using optical brighteners, histopathology and culture are strongly recommended. Serum and BAL galactomannan measures are recommended as markers for the diagnosis of IA. PCR should be considered in conjunction with other diagnostic tests. Pathogen identification to species complex level is strongly recommended for all clinically relevant Aspergillus isolates; antifungal susceptibility testing should be performed in patients with invasive disease in regions with resistance found in contemporary surveillance programmes. Isavuconazole and voriconazole are the preferred agents for first-line treatment of pulmonary IA, whereas liposomal amphotericin B is moderately supported. Combinations of antifungals as primary treatment options are not recommended. Therapeutic drug monitoring is strongly recommended for patients receiving posaconazole suspension or any form of voriconazole for IA treatment, and in refractory disease, where a personalized approach considering reversal of predisposing factors, switching drug class and surgical intervention is also strongly recommended. Primary prophylaxis with posaconazole is strongly recommended in patients with acute myelogenous leukaemia or myelodysplastic syndrome receiving induction chemotherapy. Secondary prophylaxis is strongly recommended in high-risk patients. We strongly recommend treatment duration based on clinical improvement, degree of immunosuppression and response on imaging. © 2018 European Society of Clinical Microbiology and Infectious Diseases

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Документы

Источник

Версии

  • 1. Version of Record от 2021-04-27

Метаданные

Об авторах
  • A. Ullmann
    Department of Infectious Diseases, Haematology and Oncology, University Hospital Würzburg, Würzburg, Germany
  • J. Aguado
    Infectious Diseases Unit, University Hospital Madrid, Madrid, Spain
  • S. Arikan-Akdagli
    Department of Medical Microbiology, Hacettepe University Medical School, Ankara, Turkey
  • D. Denning
    The National Aspergillosis Centre, Wythenshawe Hospital, Mycology Reference Centre Manchester, Manchester University NHS Foundation Trust, ECMM Excellence Centre of Medical Mycology, Manchester, United Kingdom
  • A. Groll
    The University of Manchester, Manchester, United Kingdom
  • K. Lagrou
    Manchester Academic Health Science Centre, Manchester, United Kingdom
  • C. Lass-Flörl
    Department of Paediatric Haematology/Oncology, Centre for Bone Marrow Transplantation, University Children's Hospital Münster, Münster, Germany
  • R. Lewis
    Department of Microbiology and Immunology, ECMM Excellence Centre of Medical Mycology, University Hospital Leuven, Leuven, Belgium
  • P. Munoz
    Institute of Hygiene, Microbiology and Social Medicine, ECMM Excellence Centre of Medical Mycology, Medical University Innsbruck, Innsbruck, Austria
  • P. Verweij
    Infectious Diseases Clinic, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
  • A. Warris
    Department of Medical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
  • F. Ader
    CIBER Enfermedades Respiratorias - CIBERES (CB06/06/0058), Madrid, Spain
  • M. Akova
    Medicine Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
  • M. Arendrup
    Department of Medical Microbiology, Radboud University Medical Centre, Centre of Expertise in Mycology Radboudumc/CWZ, ECMM Excellence Centre of Medical Mycology, Nijmegen, Netherlands
  • R. Barnes
    MRC Centre for Medical Mycology, Institute of Medical Sciences, University of Aberdeen, Aberdeen, United Kingdom
  • C. Beigelman-Aubry
    Department of Infectious Diseases, Hospices Civils de Lyon, Lyon, France
  • S. Blot
    Inserm 1111, French International Centre for Infectious Diseases Research (CIRI), Université Claude Bernard Lyon 1, Lyon, France
  • E. Bouza
    Department of Medicine, Section of Infectious Diseases, Hacettepe University Medical School, Ankara, Turkey
  • R. Brüggemann
    Department Microbiological Surveillance and Research, Statens Serum Institute, Copenhagen, Denmark
  • D. Buchheidt
    Department of Medical Microbiology and Infectious Diseases, Institute of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, United Kingdom
  • J. Cadranel
    Department of Diagnostic and Interventional Radiology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
  • E. Castagnola
    Department of Internal Medicine, Ghent University, Ghent, Belgium
  • A. Chakrabarti
    Burns, Trauma and Critical Care Research Centre, University of Queensland, Brisbane, Australia
  • M. Cuenca-Estrella
    Radboud Centre for Infectious Diseases, Radboud University Medical Centre, Centre of Expertise in Mycology Radboudumc/CWZ, ECMM Excellence Centre of Medical Mycology, Nijmegen, Netherlands
  • G. Dimopoulos
    Medical Clinic III, University Hospital Mannheim, Mannheim, Germany
  • J. Fortun
    Department of Pneumology, University Hospital of Tenon and Sorbonne, University of Paris, Paris, France
  • J. Gangneux
    Infectious Diseases Unit, Istituto Giannina Gaslini Children's Hospital, Genoa, Italy
  • J. Garbino
    Department of Medical Microbiology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
  • W. Heinz
    Instituto de Salud Carlos III, Madrid, Spain
  • R. Herbrecht
    Department of Critical Care Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
  • C. Heussel
    Infectious Diseases Service, Ramón y Cajal Hospital, Madrid, Spain
  • C. Kibbler
    Univ Rennes, CHU Rennes, Inserm, Irset (Institut de Recherche en santé environnement et travail) – UMR_S 1085, Rennes, France
  • N. Klimko
    Division of Infectious Diseases, University Hospital of Geneva, Geneva, Switzerland
  • B. Kullberg
    Department of Haematology and Oncology, University Hospital of Strasbourg, Strasbourg, France
  • C. Lange
    Diagnostic and Interventional Radiology, Thoracic Clinic, University Hospital Heidelberg, Heidelberg, Germany
  • T. Lehrnbecher
    Centre for Medical Microbiology, University College London, London, United Kingdom
  • J. Löffler
    Department of Clinical Mycology, Allergy and Immunology, North Western State Medical University, St Petersburg, Russian Federation
  • O. Lortholary
    International Health and Infectious Diseases, University of Lübeck, Lübeck, Germany
  • J. Maertens
    Clinical Infectious Diseases, Research Centre Borstel, Leibniz Center for Medicine & Biosciences, Borstel, Germany
  • O. Marchetti
    German Centre for Infection Research (DZIF), Tuberculosis Unit, Hamburg-Lübeck-Borstel-Riems Site, Lübeck, Germany
  • J. Meis
    Division of Paediatric Haematology and Oncology, Hospital for Children and Adolescents, Johann Wolfgang Goethe-University, Frankfurt, Germany
  • L. Pagano
    Department of Infectious and Tropical Diseases, Children's Hospital, University of Paris, Paris, France
  • P. Ribaud
    Department of Haematology, ECMM Excellence Centre of Medical Mycology, University Hospital Leuven, Leuven, Belgium
  • M. Richardson
    Infectious Diseases Service, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland
  • E. Roilides
    Department of Medicine, Ensemble Hospitalier de la Côte, Morges, Switzerland
  • M. Ruhnke
    Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Centre of Expertise in Mycology Radboudumc/CWZ, ECMM Excellence Centre of Medical Mycology, Nijmegen, Netherlands
  • M. Sanguinetti
    Department of Haematology, Universita Cattolica del Sacro Cuore, Roma, Italy
  • D. Sheppard
    Quality Unit, Pôle Prébloc, Saint-Louis and Lariboisière Hospital Group, Assistance Publique-Hôpitaux de Paris, Paris, France
  • J. Sinkó
    Infectious Diseases Unit, 3rd Department of Paediatrics, Faculty of Medicine, Aristotle University School of Health Sciences, Thessaloniki, Greece
  • A. Skiada
    Hippokration General Hospital, Thessaloniki, Greece
  • M. Vehreschild
    Department of Haematology and Oncology, Paracelsus Hospital, Osnabrück, Germany
  • C. Viscoli
    Institute of Microbiology, Fondazione Policlinico Universitario A. Gemelli – Università Cattolica del Sacro Cuore, Rome, Italy
  • O. Cornely
    Division of Infectious Diseases, Department of Medicine, Microbiology and Immunology, McGill University, Montreal, Canada
Название журнала
  • Clinical Microbiology and Infection
Том
  • 24
Страницы
  • e1-e38
Ключевые слова
  • amphotericin B lipid complex; caspofungin; echinocandin; galactomannan; isavuconazole; itraconazole; micafungin; posaconazole; voriconazole; antifungal agent; flucytosine; fungus antibody; isavuconazole; itraconazole; mannan; nitrile; posaconazole; pyridine derivative; triazole derivative; voriconazole; acute myeloid leukemia; adult; allogeneic hematopoietic stem cell transplantation; antifungal susceptibility; antifungal therapy; Article; bronchoscopy; combination drug therapy; computer assisted tomography; controlled study; disease predisposition; drug monitoring; hematopoietic stem cell transplantation; histopathology; human; induction chemotherapy; invasive aspergillosis; lung aspergillosis; lung lavage; myelodysplastic syndrome; practice guideline; priority journal; treatment duration; aspergillosis; Aspergillus; biopsy; blood; complication; disease management; drug effect; early diagnosis; immunocompromised patient; immunological procedures; immunology; invasive aspergillosis; isolation and purification; microbial sensitivity test; nuclear magnetic resonance imaging; practice guideline; procedures; x-ray computed tomography; Antibodies, Fungal; Antifungal Agents; Aspergillosis; Aspergillus; Biopsy; Bronchoalveolar Lavage; Disease Management; Early Diagnosis; Flucytosine; Humans; Immunocompromised Host; Immunologic Tests; Invasive Pulmonary Aspergillosis; Itraconazole; Leukemia, Myeloid, Acute; Magnetic Resonance Imaging; Mannans; Microbial Sensitivity Tests; Myelodysplastic Syndromes; Nitriles; Pyridines; Tomography, X-Ray Computed; Triazoles; Voriconazole
Издатель
  • Elsevier B.V.
Тип документа
  • journal article
Тип лицензии Creative Commons
  • CC BY-NC-ND
Правовой статус документа
  • Свободная лицензия
Источник
  • scopus
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