Therapeutic Challenges of Non-Aspergillus Invasive Mold Infections in Immunosuppressed Patients.

Détails

ID Serval
serval:BIB_DFF4349F2518
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Therapeutic Challenges of Non-Aspergillus Invasive Mold Infections in Immunosuppressed Patients.
Périodique
Antimicrobial agents and chemotherapy
Auteur⸱e⸱s
Lamoth F., Kontoyiannis D.P.
ISSN
1098-6596 (Electronic)
ISSN-L
0066-4804
Statut éditorial
Publié
Date de publication
11/2019
Peer-reviewed
Oui
Volume
63
Numéro
11
Langue
anglais
Notes
Publication types: Journal Article ; Review
Publication Status: epublish
Résumé
While Aspergillus spp. remain the major cause of invasive mold infections in hematologic cancer patients and transplant recipients, other opportunistic molds, such as Mucorales, Fusarium, and Scedosporium spp. are increasingly encountered in an expanding population of patients with severe and prolonged immunosuppression. High potential for tissue invasion and dissemination, resistance to multiple antifungals and high mortality rates are hallmarks of these non-Aspergillus invasive mold infections (NAIMIs). Assessment of drug efficacy is particularly difficult in the complex treatment scenarios of NAIMIs. Specifically, correlation between in vitro susceptibility and in vivo responses to antifungals is hard to assess, in view of the multiple, frequently interrelated factors influencing outcomes, such as pharmacokinetic/pharmacodynamic parameters determining drug availability at the site of infection, the net state of immune suppression, delay in diagnosis, or surgical debulking of infectious foci. Our current therapeutic approach of NAIMIs should evolve toward a better integration of the dynamic interactions between the pathogen, the drug and the host. Innovative concepts of experimental research may consist in manipulating the host immune system to induce a specific antifungal response or targeted drug delivery. In this review, we discuss the challenges in the management of NAIMIs and provide an update about the latest advances in diagnostic and therapeutic approaches.
Mots-clé
Fusarium, Lomentospora, Mucor, Rhizopus, Scedosporium, amphotericin B, azole, fusariosis, isavuconazole, mucormycosis, posaconazole, scedosporiosis, voriconazole
Pubmed
Web of science
Création de la notice
13/09/2019 17:13
Dernière modification de la notice
08/09/2020 5:23
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