TAILIEUCHUNG - Báo cáo khoa học: "A validated clinical approach for the management of aspergillosis in critically ill patients: ready, steady, go"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: A validated clinical approach for the management of aspergillosis in critically ill patients: ready, steady, go! | Available online http content 10 2 132 Commentary A validated clinical approach for the management of aspergillosis in critically ill patients ready steady go Jose Garnacho-Montero and Rosario Amaya-Villar Intensive Care Unit Hospital Universitario Virgen del Rocío Sevilla Spain Corresponding author Jose Garnacho-Montero Published 21 March 2006 This article is online at http content 10 2 132 2006 BioMed Central Ltd Critical Care 2006 10 132 doi cc4860 See related research by Vandewoude et al. in issue http content 10 1 R31 Abstract The clinical relevance of recovering Aspergillus species in intensive care unit patients is unknown. Diagnosis of invasive pulmonary aspergillosis is extremely difficult because there are no specific tests sensitive enough to detect it. The rapidly fatal prognosis of this infection without treatment justifies early antifungal therapy. A clinical algorithm may aid clinicians to manage critically ill patients from whose respiratory specimens Aspergillus spp. have been isolated. This new tool needs to be validated in a large cohort of patients before it can be recommended. The management of critically ill patients with a suspected invasive fungal infection based on predefined clinical and microbiological criteria or the punctuation of a score may be a valid approach when the definitive diagnosis is feasible only in a small proportion of patients. This is what Vandewoude and colleagues propose with their retrospective analysis of all patients who had Aspergillus spp. isolated from their respiratory samples 1 . Fungal infections have increased in intensive care units ICUs over the past decades. Although less common than candidiasis aspergillosis is more likely to result in a life-threatening infection. The most important host defences against Aspergillus are neutrophils and alveolar macrophages. Thus neutropenic patients and those who receive long-lasting

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