真菌感染的实验室诊断研究进展

Technical advances in laboratory diagnosis of fungal infection

随着易感人群逐渐增多，对临床真菌感染标本的快速检测及真菌培养的分离鉴定日益重要。所幸目前有新的检测方法用来辅助早期诊断及指导经验性的扰真菌治疗。主要的进展集中在对标本的真菌抗原直接检测方面（如半乳甘露聚糖和β-葡聚糖）；假丝酵母产色培养基等快速培养鉴定法；微生物生化自动分析系统（VITEK2）和显微扫描（MicroScan）等生化自动检测串板；多肽核苷酸原位杂交，特异性的大范围聚合酶链反应（PCR）检测以及针对临床标本或培养阳性标本直接DNA测序技术。

Rapid detection and identification of fungi from clinical specimens and culture isolates has become increasingly important as the number of patients susceptible to these infections continues to grow. Fortunately, new assays have been recently developed to aid early diagnosis and guide appropriate empiric anti-fungal therapy. Major improvement has been focused on direct detection of fungal antigen in specimens （e. g. , galactomannan and beta glucan）; rapid culture-based identification methods including ehromogenic Candida agar; automated biochemical test panels such as VITEK 2 and MicroScan; and molecular assays including peptide nucleic acid fluorescent in situ hybridization （PNA-FISH）, specific and broad range polymerase chain reaction （PCR） assays, and DNA-based sequencing technology use to identify organisms directly from clinical specimens or positive cultures.