认知侵袭性真菌感染的实验室诊断课件

认知侵袭性真菌感染的实验室诊断汇报人杨烨建Valadononry.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL何为侵袭性真菌感染?Valadononry.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyLDFI(deepfungalinfection真菌侵犯毛发、表皮、甲床以外的组织(皮下组织、黏膜、肌肉、内脏器官、中枢神经系统等)引起的感染。Valadononry.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL>IFI(invasivefungalinfectionDF中急、危、重者。真菌在组织器官或血液中生长繁殖,导致炎症反应和组织器官损伤,常伴多器官功能障碍。Valadononry.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyLIF诊断依据Valadononry.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL>HF诊断依据EORTC和NIAIDIMSG2019年修订标准,国内各学会诊治指南。旧F诊断分级:·拟诊(possible)临床诊断(probable)确诊(proven)Valadononry.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL>旧F分级诊断标准诊断高危临床微生物学组织病理级别因素特征检查学证据拟诊临床诊断确诊Valadononry.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL>有确诊价值的微生物学检查(1)血液真菌培养阳性,但曲霉、青霉(马尔尼菲青霉除外)需排除污染。2)导管相关性真菌血症,导管培养与血培养均阳性,且为同一真菌。(3)胸水真菌培养阳性。(4)肺组织真菌培养阳性。(5)合格瘊标本或BALF镜检发现肺孢子菌包囊、滋养体或囊内小体(6)胸水、CsF、血液直接镜检发现新生隐球菌7)直接导尿培养念珠菌>105cFU/m。Valadononry.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL常见IFI病原的诊断Valadononry.chAsposeslidesforNET4odientPEvaluatio