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

Details

Serval ID
serval:BIB_DFF4349F2518
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Therapeutic Challenges of Non-Aspergillus Invasive Mold Infections in Immunosuppressed Patients.
Journal
Antimicrobial agents and chemotherapy
Author(s)
Lamoth F., Kontoyiannis D.P.
ISSN
1098-6596 (Electronic)
ISSN-L
0066-4804
Publication state
Published
Issued date
11/2019
Peer-reviewed
Oui
Volume
63
Number
11
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: epublish
Abstract
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.
Keywords
Fusarium, Lomentospora, Mucor, Rhizopus, Scedosporium, amphotericin B, azole, fusariosis, isavuconazole, mucormycosis, posaconazole, scedosporiosis, voriconazole
Pubmed
Web of science
Create date
13/09/2019 18:13
Last modification date
08/09/2020 6:23
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