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

Détails

ID Serval
serval:BIB_C63D7082A6A5
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
Titre
Diagnosis and management of Aspergillus diseases: executive summary of the 2017 ESCMID-ECMM-ERS guideline.
Périodique
Clinical microbiology and infection
Auteur(s)
Ullmann A.J., Aguado J.M., Arikan-Akdagli S., Denning D.W., Groll A.H., Lagrou K., Lass-Flörl C., Lewis R.E., Munoz P., Verweij P.E., Warris A., Ader F., Akova M., Arendrup M.C., Barnes R.A., Beigelman-Aubry C., Blot S., Bouza E., Brüggemann RJM, Buchheidt D., Cadranel J., Castagnola E., Chakrabarti A., Cuenca-Estrella M., Dimopoulos G., Fortun J., Gangneux J.P., Garbino J., Heinz W.J., Herbrecht R., Heussel C.P., Kibbler C.C., Klimko N., Kullberg B.J., Lange C., Lehrnbecher T., Löffler J., Lortholary O., Maertens J., Marchetti O., Meis J.F., Pagano L., Ribaud P., Richardson M., Roilides E., Ruhnke M., Sanguinetti M., Sheppard D.C., Sinkó J., Skiada A., Vehreschild MJGT, Viscoli C., Cornely O.A.
ISSN
1469-0691 (Electronic)
ISSN-L
1198-743X
Statut éditorial
Publié
Date de publication
05/2018
Peer-reviewed
Oui
Volume
24 Suppl 1
Pages
e1-e38
Langue
anglais
Notes
Publication types: Journal Article ; Practice Guideline
Publication Status: ppublish
Résumé
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.
Mots-clé
Antibodies, Fungal/blood, Antifungal Agents/pharmacology, Antifungal Agents/therapeutic use, Aspergillosis/complications, Aspergillosis/diagnosis, Aspergillosis/drug therapy, Aspergillosis/immunology, Aspergillus/drug effects, Aspergillus/immunology, Aspergillus/isolation & purification, Biopsy/methods, Bronchoalveolar Lavage, Disease Management, Early Diagnosis, Flucytosine/pharmacology, Flucytosine/therapeutic use, Humans, Immunocompromised Host, Immunologic Tests, Invasive Pulmonary Aspergillosis/diagnosis, Itraconazole/pharmacology, Itraconazole/therapeutic use, Leukemia, Myeloid, Acute/complications, Leukemia, Myeloid, Acute/therapy, Magnetic Resonance Imaging, Mannans/analysis, Microbial Sensitivity Tests, Myelodysplastic Syndromes/complications, Myelodysplastic Syndromes/therapy, Nitriles/pharmacology, Nitriles/therapeutic use, Pyridines/pharmacology, Pyridines/therapeutic use, Tomography, X-Ray Computed, Triazoles/pharmacology, Triazoles/therapeutic use, Voriconazole/pharmacology, Voriconazole/therapeutic use, Aspergillosis, Diagnosis, Haematology, Invasive fungal infection, Transplantation, Treatment
Pubmed
Web of science
Création de la notice
22/03/2018 21:10
Dernière modification de la notice
04/01/2019 7:26
Données d'usage