بهداشت و بیماری‌های عفونی دام

بهداشت و بیماری‌های عفونی دام

آسپرژیلوزیس مهاجم- یک مقاله مروری

نوع مقاله : مروری

نویسندگان
1 گروه میکروبیولوژی و ایمنولوژی، دانشکده دامپزشکی، دانشگاه تهران، تهران
2 گروه قارچ شناسی پزشکی، دانشکده پزشکی، دانشگاه علوم پزشکی جندی شاپور اهواز، اهواز، ایران
چکیده
آسپرژیلوزیس مهاجم یک بیماری قارچی تهدید کننده زندگی است که باعث عوارض و مرگ و میر بالایی در بیمارانی که سیستم ایمنی آنها سرکوب شده است می گردد. شایع ترین گونه های آسپرژیلوس که موجب آسپرژیلوزیس مهاجم می گردند، آسپرژیلوس فومیگاتوس و پس از آن آسپرزیلوس ترئوس و آسپرژیلوس فلاووس هستند. آسپرژیلوس میتواند طیف وسیعی از سندروم های کلینیکی از یک کلونیزاسیون ساده تا یک فرم مهاجم را ایجاد کند. شایع ترین فرم بیماری آسپرژیلوزیس ریوی بوده و آسپرژیلوس فومیگاتوس عامل اکثر موارد آسپرژیلوزیس ریوی است. چندین فاکتور پاتوژنیک آسپرژیلوس فومیگاتوس شناخته شده است. نوتروپنی پر ریسک ترین فاکتور در ابتلا به این بیماری است. با وجود افزایش شیوع آسپرژیلوزیس مهاجم، تشخیص سریع، دقیق و درمان این بیماری همچنان مورد بحث است. با توجه به طیف وسیع علائم بالینی غیراختصاصی و نیز کاستی‌های تکنیک‌های تشخیصی کنونی، بیشتر بیماران یا به‌عنوان موارد «ممکن» یا «احتمالی» تشخیص داده می‌شوند. علاوه بر این، به دلیل فقدان تست‌های حساس و اختصاصی، بسیاری از بیماران پرخطر یک درمان تجربی و یا طولانی‌مدت از داروهای ضد قارچی که قیمت بالایی نیز دارند دریافت کرده که منجر به عوارض جانبی ناشی از دارو شده و احتمال مقاومت دارویی قارچ بالا می رود. تکنیک‌های تشخیصی دقیق‌تر در کنار درمان هدفمند ضد قارچی، الزامات اساسی برای کاهش عوارض و مرگ‌ومیر آسپرژیلوزیس مهاجم هستند. در این بررسی، آسپرژیلوزیس مهاجم از لحاظ عوامل، اپیدمیولوژی، اشکال کلینیکال، تشخیص و درمان مرور می گردد. همچنین جدیدترین پیشرفت هایی که در تشخیص و درمان این بیماری صورت گرفته است مورد مطالعه قرار می گیرد.
کلیدواژه‌ها
موضوعات

عنوان مقاله English

Invasive aspergillosis

نویسندگان English

Narges Bastami 1
Majid Zarrin 2
1 Department of Microbiology and Immunology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
2 Department of Medical Mycology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
چکیده English

Background and Aim: Invasive aspergillosis is a life-threatening fungal disease that causes high morbidity and
mortality in patients withsuppressed immune system. The most common Aspergillus species that cause invasive
aspergillosis are Aspergillus fumigatus, followed by Aspergillus terreus and Aspergillus flavus. Aspergillus can cause a
wide range of clinical syndromes from a simple colonization to an invasive form. The most common form of this disease is pulmonary aspergillosis, and Aspergillus fumigatus is the cause of most cases of pulmonary aspergillosis. Several pathogenic factors of Aspergillus fumigatus are known.Neutropenia is the mostcommon risk factor for this disease.
Despite the increasing prevalence of invasive aspergillosis, rapid, accurate diagnosis and treatment of this disease are
still important. Due to the wide range of non-specific clinical signs as well as the shortcomings of current diagnostic
techniques, most patients are diagnosed either as "possible" or "probable" cases. In addition, due to the lack of sensitive and specific tests, many high-risk patients received an experimental or long-term treatment of antifungal drugs that are also expensive, which led to drug-induced side effects and the possibility of fungal drug resistance going up. More accurate diagnostic techniques, along with targeted antifungal therapy, are essential requirements to reduce the morbidity and mortality of invasive aspergillosis.
Conclusion: In this review, invasive aspergillosis is surveyed in terms of causes, epidemiology, clinical forms,
diagnosis, and treatment. Also, the latest developments in the diagnosis tests and treatment of this infection are studied.
Keywords: Invasive aspergillosis, Aspergillusgenus, Aspergillus fumigatus, Diagnosis, Treatment

کلیدواژه‌ها English

Invasive aspergillosis
Aspergillusgenus
Aspergillus fumigatus
Diagnosis
Treatment
 
1.             Aruanno M, Glampedakis E, Lamoth F. Echinocandins for the treatment of invasive aspergillosis: from laboratory to bedside. Antimicrobial agents and chemotherapy. 2019;63(8):10.1128/aac. 00399-19.
2.             Mayer A. Deutsch Arch Physiol. 1815.
3.             Bennett J. XXIV.—On the Parasitic Vegetable Structures found growing in Living Animals. Journal of Natural History. 1843;11(68):126-7.
4.             Rankin N. Disseminated aspergillosis and moniliasis associated with agranulocytosis and antibiotic therapy. British medical journal. 1953;1(4816):918.
5.             Jenks JD, Nam HH, Hoenigl M. Invasive aspergillosis in critically ill patients: Review of definitions and diagnostic approaches. Mycoses. 2021(9):1002-14.
6.             Rudramurthy SM, Paul RA, Chakrabarti A, Mouton JW, Meis JF. Invasive aspergillosis by Aspergillus flavus: epidemiology, diagnosis, antifungal resistance, and management. Journal of Fungi. 2019;5(3):55.
7.             Danion F, Rouzaud C, Duréault A, Poirée S, Bougnoux M-E, Alanio A, et al. Why are so many cases of invasive aspergillosis missed? Medical mycology. 2019;57(Supplement_2):S94-S103.
8.             Gibbons JG, Rokas A. The function and evolution of the Aspergillus genome. Trends in microbiology. 2013;21(1):14-22.
9.             Thompson III GR, Young J-AH. Aspergillus infections. New England Journal ofMedicine. 2021;385(16):1496-509.
10.          Chakrabarti A, Chatterjee SS, Das A, Shivaprakash M. Invasive aspergillosis in developing countries. Medical mycology. 2011;49(Supplement_1):S35-S47.
11.          Latgé J-P, Chamilos G. Aspergillus fumigatus and Aspergillosisin 2019. Clinical microbiology reviews. 2019;33(1):10.1128/cmr. 00140-18.
12.          Kanaujia R, Singh S, Rudramurthy SM. Aspergillosis: an Update on Clinical Spectrum, Diagnostic Schemes, and Management. Current Fungal Infection Reports. 2023:1-12.
13.          Gregg KS, Kauffman CA, editors. Invasive aspergillosis: epidemiology, clinical aspects, and treatment. Seminars in respiratory and critical care medicine; 2015: Thieme Medical Publishers.
14.          Kumagai T, Nagata T, Kudo Y, Fukuchi Y, Ebina K, Yokota K. Cytotoxic activity and cytokine gene induction of Asp-hemolysin to vascular endothelial cells. Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan. 2001;121(4):271-5.
15.          Zarrin M, Ganj F. Study of Hemolysin Gene aspHS” and Its Phenotype in Aspergillus Fumigatus. Open Access Maced J Med Sci. 2019 Aug 15; 7 (15): 2399-2403. 2019.
16.          Kumar A, Reddy LV, Sochanik A, Kurup VP. Isolation and characterization of a recombinant heat shock protein of Aspergillus fumigatus. Journal of allergy and clinical immunology. 1993;91(5):1024-30.
17.          Latgé J-P. Aspergillus fumigatus and aspergillosis. Clinical microbiology reviews. 1999;12(2):310-50.
18.          del Palacio A, Alhambra A, Cuétara MS, Pontón J. Early diagnosis of invasive fungal infections caused by Aspergillus and other emerging mycelial fungi. Revista iberoamericana de micologia. 2007;24(3):187-97.
19.          Pastor FJ, Guarro J. Treatment of Aspergillus terreus infections: a clinical problem not yet resolved. International journal of antimicrobial agents. 2014;44(4):281-9.
20.          Hachem R, Gomes MZR, El Helou G, El Zakhem A, Kassis C, Ramos E, et al. Invasive aspergillosis caused by Aspergillus terreus: an emerging opportunistic infection with poor outcome independent of azole therapy. Journal of Antimicrobial Chemotherapy. 2014;69(11):3148-55.
21.          Singh S, Verma N, Kanaujia R, Chakrabarti A, Rudramurthy SM. Mortality in critically ill patients with coronavirus disease 2019associated pulmonary aspergillosis: a systematic review and metaanalysis. Mycoses. 2021;64(9):1015-27.
22.          Taccone FS, Van den Abeele A-M, Bulpa P, Misset B, Meersseman W, Cardoso T, et al. Epidemiology of invasive aspergillosis in critically ill patients: clinical presentation, underlying conditions, and outcomes. Critical Care. 2015;19(1).
23.          Brown GD, Denning DW, Gow NA, Levitz SM, Netea MG, White TC. Hidden killers: human fungal infections. Science translational medicine. 2012;4(165):165rv13-rv13.
24.          Zilberberg MD, Nathanson BH, Harrington R, Spalding JR, Shorr AF. Epidemiology and outcomes of hospitalizations with invasive aspergillosis in the United States, 2009–2013. Clinical Infectious Diseases. 2018;67(5):727-35.
25.          Yerbanga IW, Diallo SN, Rouamba T, Denis O, Rodriguez-Villalobos H, Montesinos I, et al. A systematic review of epidemiology, risk factors, diagnosis, antifungal resistance, and management of invasive aspergillosis in Africa. Journal of Medical Mycology. 2023;33(1):101328.
26.          Darling BA, Milder EA. Invasive aspergillosis. American Academy of Pediatrics; 2018.
27.          Engel TG, ErrenE, Driessche KSV, Melchers WJ, Reijers MH, Merkus P, et al. Aerosol transmission of Aspergillus fumigatus in cystic fibrosis patients in the Netherlands. Emerging infectious diseases. 2019;25(4):797.
28.          Tavakoli M, Hedayati MT, Mirhendi H, Nouripour-Sisakht S, Hedayati N, Saghafi F, et al. The first rare and fatal case of invasive aspergillosis of spinal cord due to Aspergillus nidulans in an Iranian child with chronic granulomatosis disease: review of literature. Current medical mycology. 2020;6(1):55.
29.          Kami M, Fukui T, Ogawa S, Kazuyama Y, Machida U, Tanaka Y, et al. Use of real-time PCR on blood samples for diagnosis of invasive aspergillosis. Clinical Infectious Diseases. 2001;33(9):1504-12.
30.          Arastehfar A, Carvalho A, van de Veerdonk FL, JenksJD, Koehler P, Krause R, et al. COVID-19 associated pulmonary aspergillosis (CAPA)—from immunology to treatment. Journal of Fungi. 2020;6(2):91.
31.          Thompson Iii GR, Cornely OA, Pappas PG, Patterson TF, Hoenigl M, Jenks JD, et al., editors. Invasive aspergillosis as an under-recognized superinfection in COVID-19. Open forum infectious diseases; 2020: Oxford University Press US.
32.          Lamoth F. Galactomannan and 1, 3-β-d-Glucan Testing for the Diagnosis of Invasive Aspergillosis. Journal of Fungi. 2016;2(3):22.
33.          Fontana C, Gaziano R, Favaro M, Casalinuovo I, Pistoia E, Di Francesco P. (1-3)-β-D-glucan vs galactomannan antigen in diagnosing invasive fungal infections (IFIs). The Open Microbiology Journal. 2012;6:70.
34.          Powers-Fletcher MV, Hanson KE. Molecular diagnostic testing for Aspergillus. Journal of clinical microbiology. 2016;54(11):2655-60.
35.          Perlin DS, Zhao Y. Molecular diagnostic platforms for detecting Aspergillus. Medical Mycology. 2009;47(sup1):S223-S32.
36.          Zarrin M, Erfaninejad M. Molecular variation analysis of Aspergillus flavus using polymerase chain reaction-restriction fragment length polymorphism of the internal transcribed spacer rDNA region. Experimental and Therapeutic Medicine. 2016;12(3):1628-32.
37.          Valdes ID, van den Berg J, Haagsman A, Escobar N, Meis JF, Hagen F, et al. Comparative genotyping and phenotyping of Aspergillus fumigatus isolates from humans, dogs and the environment. BMC microbiology. 2018;18(1):1-11.
38.          Ramšak B, Markau J, Pazen T, Dahlmann TA, Krappmann S, Kück U. The master regulator MAT1-1-1 of fungal mating binds to its targets via a conserved motif in the human pathogen Aspergillus fumigatus. G3. 2021;11(2):jkaa012.
39.          Zarrin M, Rashidnia Z, Faramarzi S, Harooni L. Rapid Identification of Aspergillus Fumigatus Using Βeta-Tubulin and RodletA Genes. Open access Macedonian journal of medical sciences. 2017;5(7):848.
40.          Boch T, Reinwald M, Spiess B, Liebregts T, Schellongowski P, Meybohm P, et al. Detection of invasive pulmonary aspergillosis in critically ill patients by combined use of conventional culture, galactomannan, 1-3-beta-D-glucan and Aspergillus specific nested polymerase chain reaction in a prospective pilot study. Journal of Critical Care. 2018;47:198-203.
41.          Alanio A, Dellière S, Fodil S, Bretagne S, Mégarbane B. Prevalence of putative invasive pulmonary aspergillosis in critically ill patients with COVID-19. The Lancet Respiratory Medicine. 2020;8(6):e48-e9.
42.          Cento V, Alteri C, Mancini V, Gatti M, Lepera V, Mazza E, et al. Quantification of 1, 3βdglucan by Wako βglucan assay for rapid exclusion of invasive fungal infections in critical patients: A diagnostic test accuracy study. Mycoses. 2020;63(12):1299-310.
43.          Koehler P, Bassetti M, Chakrabarti A, Chen SC, Colombo AL, Hoenigl M, et al. Defining and managing COVID-19-associated pulmonary aspergillosis: the 2020 ECMM/ISHAM consensus criteria for research and clinical guidance. The Lancet Infectious Diseases. 2021;21(6):e149-e62.
44.          Hsu T-H, Huang P-Y, Fan Y-C, Sun P-L. Azole resistance and cyp51A mutation of aspergillus fumigatus in a tertiary referral hospital in Taiwan. Journal of Fungi. 2022;8(9):908.

  • تاریخ دریافت 20 مهر 1402
  • تاریخ بازنگری 21 آبان 1402
  • تاریخ پذیرش 11 بهمن 1402
  • تاریخ اولین انتشار 19 بهمن 1402
  • تاریخ انتشار 01 دی 1403