ABSTRACT

Introduction

The spectrum of disease caused by Aspergillus spp. is dependent on the immune system of the host, with invasive aspergillosis (IA) its most severe manifestation. Early and reliable diagnosis of Aspergillus disease is important to decrease associated morbidity and mortality from IA.

Areas covered

The following review searched Pub Med for literature published since 2007 and will give an update on the current point-of-care diagnostic strategies for the diagnosis of IA, discuss needed areas of improvement for these tests, and future directions.

Expert opinion

Several new diagnostic tests for IA – including point-of-care tests – are now available to complement conventional galactomannan (GM) testing. In particular, the Aspergillus-specific Lateral Flow Device (LFD) test and the sōna Aspergillus GM Lateral Flow Assay (LFA) are promising for the diagnosis of IA in patients with hematologic malignancy, although further evaluation in the non-hematology setting is needed. In addition, a true point-of-care test, particularly for easily obtained specimens like serum or urine that can be done at the bedside or in the Clinic in a matter of minutes is needed, such as the lateral flow dipstick test, which is under current evaluation. Lastly, improved diagnostic algorithms to diagnose IA in non-neutropenic patients is needed.

中文翻译：

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侵袭性曲霉病的即时诊断：接近终点线。

摘要

介绍

由曲霉属引起的疾病谱。依赖于宿主的免疫系统，侵袭性曲霉病 (IA) 是其最严重的表现。曲霉菌病的早期和可靠诊断对于降低相关的 IA 发病率和死亡率很重要。

覆盖区域

以下综述在 Pub Med 中搜索了自 2007 年以来发表的文献，并将提供当前诊断 IA 的即时诊断策略的更新，讨论这些测试需要改进的领域以及未来的方向。

专家意见

几种新的 IA 诊断测试 - 包括即时检验 - 现在可用于补充传统的半乳甘露聚糖 (GM) 测试。特别是曲霉特异性侧流装置 (LFD) 测试和 sōna曲霉GM 侧流检测 (LFA) 有望用于诊断恶性血液病患者的 IA，但需要在非血液学环境中进行进一步评估。此外，还需要真正的即时检测，特别是对于血清或尿液等容易获得的样本，这些样本可以在床边或诊所在几分钟内完成，例如侧流试纸测试，这是在目前的评估中。最后，需要改进的诊断算法来诊断非中性粒细胞减少症患者的 IA。