吕晓菊：深部真菌感染诊断相关问题.pptVIP

* Echinocandins are highly active against a number of Candida species, with Candida parapsilosis and Candida gulliermondii having a higher MIC. In vitro killing of these species is very rapid. No activity was seen vs Zygomycetes, Cryptococcus neoformans, Fusarium spp and Trichosporon sp. * Echinocandins are highly active against a number of Candida species, with Candida parapsilosis and Candida gulliermondii having a higher MIC. In vitro killing of these species is very rapid. No activity was seen vs Zygomycetes, Cryptococcus neoformans, Fusarium spp and Trichosporon sp. * 折点是综合了体外MIC值及体内血药有效并安全的浓度，制定出S,S-dd〔或I〕,R * * 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 m