Información del artículo
Several important changes are taking place in the field of invasive fungal infections. The increasing incidence of invasive fungal infections as a result of progress in areas of medicine such as organ transplantation, cancer therapy or intensive-care medical technology has provided the impetus for a search for a new and more favorable scenario. In addition, pharmaceutical companies have developed new, well-tolerated and more effective broad-spectrum antifungal agents. Therefore, during the last few years, several articles on invasive fungal infections have been published. This review focuses on the new insights in the literature on fungal infections during 2004 and 2005. Three areas of interest have been identified: (i) epidemiology and risk factors, (ii) new diagnostic procedures, and (iii) prevention and treatment. A review of the English-language and Spanish-language literature on invasive fungal infections has been made, and those articles considered essential reading have been reviewed and discussed in order to highlight their original aspects.
Key words:
Invasive fungal infections
Systemic mycoses
Organ transplantation
En el campo de las infecciones fúngicas invasoras se están produciendo varios cambios importantes. El aumento en la incidencia de las infecciones fúngicas invasoras a consecuencia de los progresos que se han realizado en áreas de la medicina, como el trasplante de órganos, el tratamiento del cáncer y la tecnología de los cuidados médicos intensivos, ha estimulado la búsqueda de nuevos contextos más favorables. Además, las compañías farmacéuticas han desarrollado agentes antifúngicos de amplio espectro bien tolerados y más eficaces.
Así, durante los últimos años se han publicado varios artículos relativos a las infecciones fúngicas invasoras. Esta revisión está fundamentada en las publicaciones relativas a las infecciones fúngicas que han aparecido en la bibliografía médica durante los años 2004 y 2005. Se han identificado tres áreas de interés: 1) epidemiología y factores de riesgo; 2) nuevos procedimientos diagnósticos, y 3) prevención y tratamiento. Se ha realizado una revisión de la bibliografía médica en los idiomas inglés y español relativa a las infecciones fúngicas invasoras, con exposición y discussión de los artículos considerados de lectura obligada en el intento de poner de manifiesto sus aspectos originales.
Palabras clave:
Infecciones fúngicas invasoras
Micosis sistémicas
Trasplante de órganos
El Texto completo está disponible en PDF
References
[1.]
R.A. Hajjeh, A.N. Sofair, L.H. Harrison, G.M. Lyon, B.A. Arthington-Skaggs, S.A. Mirza, et al.
Incidence of bloodstream infections due to Candida species and in vitro susceptibilities of isolates collected from 1998 to 2000 in a population-based active surveillance program.
J Clin Microbiol, 42 (2004), pp. 1519-1527
[2.]
A.S. Kao, M.E. Brandt, W.R. Pruitt, L.A. Conn, B.A. Perkins, D.S. Stephens, et al.
The epidemiology of candidemia in two United States cities: Results of a population-based active surveillance.
Clinical Infectious Diseases, 29 (1999), pp. 1164-1170
[3.]
L.R. Asmundsdottir, H. Erlendsdottir, M. Gottfredsson.
Increasing incidence of candidemia: Results from a 20-year nationwide study in Iceland.
J Clin Microbiol, 40 (2002), pp. 3489-3492
[4.]
E. Poikonen, O. Lyytikainen, V.J. Anttila, P. Ruutu.
Candidemia in Finland, 1995-1999.
Emerging Infectious Diseases, 9 (2003), pp. 985-990
[5.]
B. Almirante, D. Rodriguez, B.J. Park, M. Cuenca-Estrella, A.M. Planes, M. Almela, et al.
Epidemiology and predictors of mortality in cases of Candida blood-stream infection: Results from population-based surveillance, Barcelona, Spain, from 2002 to 2003.
J Clin Microbiol, 43 (2005), pp. 1829-1835
[6.]
M.C. Arendrup, K. Fuursted, B. Gahrn-Hansen, I.M. Jensen, J.D. Knudsen, B. Lundgren, et al.
Seminational surveillance of fungemia in Denmark: Notably high rates of fungemia and numbers of isolates with reduced azole susceptibility.
J Clin Microbiol, 43 (2005), pp. 4434-4440
[7.]
J. Peman, E. Canton, M. Gobernado.
Epidemiology and antifungal susceptibility of Candida species isolated from blood: results of a 2-year multicentre study in Spain.
European Journal of Clinical Microbiology & Infectious Diseases, 24 (2005), pp. 23-30
[8.]
M. Cuenca-Estrella, C.B. Moore, F. Barchiesi, J. Bille, E. Chryssanthou, D.W. Denning, et al.
Multicenter evaluation of the reproducibility of the proposed antifungal susceptibility testing method for fermentative yeasts of the Antifungal Susceptibility Testing Subcommittee of the European Committee on Antimicrobial Susceptibility Testing (AFST-EUCAST) 32.
Clin Microbiol Infect, 9 (2003), pp. 467-474
[9.]
J.L. Rodriguez-Tudela, F. Barchiesi, J. Bille, E. Chryssanthou, M. Cuenca-Estrella, D. Denning, et al.
Method for the determination of minimum inhibitory concentration (MIC) by broth dilution of fermentative yeasts.
Clin Microbiol Infect, 9 (2003), pp. 1-8
[10.]
M. Cuenca-Estrella, D. Rodriguez, B. Almirante, J. Morgan, A.M. Planes, M. Almela, et al.
In vitro susceptibilities of bloodstream isolates of Candida species to six antifungal agents: results from a population-based active surveillance programme, Barcelona, Spain, 2002-2003.
Journal of Antimicrobial Chemotherapy, 55 (2005), pp. 194-199
[11.]
K.A. Marr, K. Seidel, T.C. White, R.A. Bowden.
Candidemia in allogeneic blood and marrow transplant recipients: Evolution of risk factors after the adoption of prophylactic fluconazole.
Journal of Infectious Diseases, 181 (2000), pp. 309-316
[12.]
W.E. Trick, S.K. Fridkin, J.R. Edwards, R.A. Hajjeh, R.P. Gaynes.
Secular trend of hospital-acquired candidemia among intensive care unit patients in the United States during 1989-1999.
Clinical Infectious Diseases, 35 (2002), pp. 627-630
[13.]
A.M. Tortorano, E. Biraghi, A. Astolfi, C. Ossi, M. Tejada, C. Farina, et al.
European Confederation of Medical Mycology (ECMM) prospective survey of candidaemia: report from one Italian region.
Journal of Hospital Infection, 51 (2002), pp. 297-304
[14.]
M.A. Pfaller, D.J. Diekema, R.N. Jones, H.S. Sader, A.C. Fluit, R.J. Hollis, et al.
International surveillance of bloodstream infections due to Candida species: Frequency of occurrence and in vitro susceptibilities to fluconazole, ravuconazole, and voriconazole of isolates collected from 1997 through 1999 in the SENTRY antimicrobial surveillance program.
J Clin Microbiol, 39 (2001), pp. 3254-3259
[15.]
J. Morgan, K.A. Wannemuehler, K.A. Marr, S. Hadley, D.P. Kontoyiannis, T.J. Walsh, et al.
Incidence of invasive aspergillosis following hematopoietic stem cell and solid organ transplantation: interim results of a prospective multicenter surveillance program.
Medical Mycology, 43 (2005), pp. S49-S58
[16.]
C. Lass-Florl, K. Griff, A. Mayr, A. Petzer, G. Gastl, H. Bonatti, et al.
Epidemiology and outcome of infections due to Aspergillus terreus: 10-year single centre experience.
British Journal of Haematology, 131 (2005), pp. 201-207
[17.]
J. Gavalda, O. Len, R.S. Juan, J.M. Aguado, J. Fortun, C. Lumbreras, et al.
Risk factors for invasive aspergillosis in solid-organ transplant recipients: A casecontrol study.
Clinical Infectious Diseases, 41 (2005), pp. 52-59
[18.]
J. Garnacho-Montero, R. Amaya-Villar, C. Ortiz-Leyba, C. Leon, F. Alvarez-Lerma, J. Nolla-Salas, et al.
Isolation of Aspergillus spp. from the respiratory tract in critically ill patients: risk factors, clinical presentation and outcome.
Critical Care, 9 (2005), pp. R191-R199
[19.]
W. Meersseman, S.J. Vandecasteele, A. Wilmer, E. Verbeken, W.E. Peetermans, E. Van Wijngaerden.
Invasive aspergillosis in critically ill patients without malignancy.
American Journal of Respiratory and Critical Care Medicine, 170 (2004), pp. 621-625
[20.]
M.M. Roden, T.E. Zaoutis, W.L. Buchanan, T.A. Knudsen, T.A. Sarkisova, R.L. Schaufele, et al.
Epidemiology and outcome of zygomycosis: A review of 929 reported cases.
Clinical Infectious Diseases, 41 (2005), pp. 634-653
[21.]
K.A. Marr, S.A. Balajee, L. McLaughlin, M. Tabouret, C. Bentsen, T.J. Walsh.
Detection of galactomannan antigenemia by enzyme immunoassay for the diagnosis of invasive aspergillosis: Variables that affect performance.
Journal of Infectious Diseases, 190 (2004), pp. 641-649
[22.]
S. Ascioglu, J.H. Rex, B. De Pauw, J.E. Bennett, J. Bille, F. Crokaert, et al.
Defining opportunistic invasive fungal infections in immunocompromised patients with cancer and hematopoietic stem cell transplants: An international consensus.
Clinical Infectious Diseases, 34 (2002), pp. 7-14
[23.]
K.A. Marr, M. Laverdiere, A. Gugel, W. Leisenring.
Antifungal therapy decreases sensitivity of the Aspergillus galactomannan enzyme immunoassay.
Clinical Infectious Diseases, 40 (2005), pp. 1762-1769
[24.]
M. Rovira, M. Jimenez, J.P. De La Bellacasa, J. Mensa, M. Rafel, M. Ortega, et al.
Detection of Aspergillus galactomannan by enzyme immunoabsorbent assay in recipients of allogeneic hematopoietic stem cell transplantation: A prospective study.
Transplantation, 77 (2004), pp. 1260-1264
[25.]
A. Upton, A. Gugel, W. Leisenring, A. Limaye, B. Alexander, R. Hayden, et al.
Reproducibility of low galactomannan enzyme immunoassay index values tested in multiple laboratories.
J Clin Microbiol, 43 (2005), pp. 4796-4800
[26.]
Z. Odabasi, G. Mattiuzzi, E. Estey, H. Kantarjian, F. Saeki, R.J. Ridge, et al.
beta-D-glucan as a diagnostic adjunct for invasive fungal infections: Validation, cutoff development, and performance in patients with acute myelogenous leukemia and myelodysplastic syndrome.
Clinical Infectious Diseases, 39 (2004), pp. 199-205
[27.]
J.W. Pickering, H.W. Sant, C.A.P. Bowles, W.L. Roberts, G.L. Woods.
Evaluation of a (1->3)-{beta}-D-Glucan Assay for Diagnosis of Invasive Fungal Infections.
J Clin Microbiol, 43 (2005), pp. 5957-5962
[28.]
L. Ostrosky-Zeichner, B.D. Alexander, D.H. Kett, J. Vazquez, P.G. Pappas, F. Saeki, et al.
Multicenter clinical evaluation of the (1 -> 3) beta-D-glucan assay as an aid to diagnosis of fungal infections in humans.
Clinical Infectious Diseases, 41 (2005), pp. 654-659
[29.]
M.A. Pfaller, D.J. Diekema, M.G. Rinaldi, R. Barnes, B. Hu, A.V. Veselov, et al.
Results from the ARTEMIS DISK global antifungal surveillance study: a 6.5- year analysis of susceptibilities of Candida and other yeast species to fluconazole and voriconazole by standardized disk diffusion testing.
J Clin Microbiol, 43 (2005), pp. 5848-5859
[30.]
M.A. Pfaller, L. Boyken, R.J. Hollis, S.A. Messer, S. Tendolkar, D.J. Diekema.
In vitro activities of anidulafungin against more than 2,500 clinical isolates of Candida spp., including 315 isolates resistant to fluconazole.
J Clin Microbiol, 43 (2005), pp. 5425-5427
[31.]
K.A. Marr, F. Crippa, W. Leisenring, M. Hoyle, M. Boeckh, S.A. Balajee, et al.
Itraconazole versus fluconazole for prevention of fungal infections in patients receiving allogeneic stem cell transplants.
Blood, 103 (2004), pp. 1527-1533
[32.]
D.J. Winston, R.T. Maziarz, P.H. Chandrasekar, H.M. Lazarus, M. Goldman, J.L. Blumer, et al.
Intravenous and Oral Itraconazole versus Intravenous and Oral Fluconazole for Long-Term Antifungal Prophylaxis in Allogeneic Hematopoietic Stem-Cell Transplant Recipients: A Multicenter, Randomized Trial.
Ann Intern Med, 138 (2003), pp. 705-713
[33.]
A.F. Shorr, K. Chung, W.L. Jackson, P.E. Waterman, M.H. Kollef.
Fluconazole prophylaxis in critically ill surgical patients: a meta-analysis.
Crit Care Med, 33 (2005), pp. 1928-1935
[34.]
R.H. Rubin.
Preemptive Therapy in Immunocompromised Hosts.
New England Journal of Medicine, 324 (1991), pp. 1057-1059
[35.]
J. Maertens, K. Theunissen, G. Verhoef, J. Verschakelen, K. Lagrou, E. Verbeken, et al.
Galactomannan and computed tomography - Based preemptive antifungal therapy in neutropenic patients at high risk for invasive fungal infection: A prospective feasibility study.
Clinical Infectious Diseases, 41 (2005), pp. 1242-1250
[36.]
R. Piarroux, F. Grenouillet, P. Balvay, W. Tran, G. Blasco, L. Millon, et al.
Assessment of preemptive treatment to prevent severe candidiasis in critically ill surgical patients.
Critical Care Medicine, 32 (2004), pp. 2443-2449
[37.]
D. Pittet, M. Monod, P.M. Suter, E. Frenk, R. Auckenthaler.
Candida Colonization and Subsequent Infections in Critically Ill Surgical Patients.
Annals of Surgery, 220 (1994), pp. 751-758
[38.]
T.J. Walsh, H. Teppler, G.R. Donowitz, J.A. Maertens, L.R. Baden, A. Dmoszynska, et al.
Caspofungin versus liposomal amphotericin B for empirical antifungal therapy in patients with persistent fever and neutropenia.
New England Journal of Medicine, 351 (2004), pp. 1391-1402
[39.]
T.J. Walsh, R.W. Finberg, C. Arndt, J. Hiemenz, C. Schwartz, D. Bodensteiner, et al.
Liposomal amphotericin B for empirical therapy in patients with persistent fever and neutropenia.
New England Journal of Medicine, 340 (1999), pp. 764-771
[40.]
T.J. Walsh, P. Pappas, D.J. Winston, H.M. Lazarus, F. Petersen, J. Raffalli, et al.
Voriconazole compared with liposomal amphotericin B for empirical antifungal therapy in patients with neutropenia and persistent fever.
New England Journal of Medicine, 346 (2002), pp. 225-234
[41.]
J. Klastersky.
Antifungal therapy in patients with fever and neutropenia - More rational and less empirical?.
New England Journal of Medicine, 351 (2004), pp. 1445-1447
[42.]
M. Morrell, V.J. Fraser, M.H. Kollef.
Delaying the empiric treatment of Candida bloodstream infection until positive blood culture results are obtained: a potential risk factor for hospital mortality.
Antimicrobial Agents and Chemotherapy, 49 (2005), pp. 3640-3645
[43.]
B.J. Kullberg, J.D. Sobel, M. Ruhnke, P.G. Pappas, C. Viscoli, J.H. Rex, et al.
Voriconazole versus a regimen of amphotericin B followed by fluconazole for candidaemia in non-neutropenic patients: a randomised non-inferiority trial.
Lancet, 366 (2005), pp. 1435-1442
[44.]
J. Maertens, I. Raad, G. Petrikkos, M. Boogaerts, D. Selleslag, F.B. Petersen, et al.
Efficacy and safety of caspofungin for treatment of invasive aspergillosis in patients refractory to or intolerant of conventional antifungal therapy.
Clinical Infectious Diseases, 39 (2004), pp. 1563-1571
[45.]
T.F. Patterson, H.W. Boucher, R. Herbrecht, D.W. Denning, O. Lortholary, P. Ribaud, et al.
Strategy of following voriconazole versus amphotericin B therapy with other licensed antifungal therapy for primary treatment of invasive aspergillosis: Impact of other therapies on outcome.
Clinical Infectious Diseases, 41 (2005), pp. 1448-1452
[46.]
R. Herbrecht, D.W. Denning, T.F. Patterson, J.E. Bennett, R.E. Greene, J.W. Oestmann, et al.
Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis.
New England Journal of Medicine, 347 (2002), pp. 408-415
[47.]
K.A. Marr, M. Boeckh, R.A. Carter, H.W. Kim, L. Corey.
Combination antifungal therapy for invasive aspergillosis.
Clinical Infectious Diseases, 39 (2004), pp. 797-802
Copyright © 2007. Elsevier España S.L.. All rights reserved
