ABSTRACT
Micro-organismos do gênero Aspergillus são fungos filamentosos, ubíquos, amplamente distribuídos na natureza com grande importância no setor agrícola, industrial, na medicina veterinária e na saúde humana, sobretudo como agente de infecção fúngica invasiva em ambientes nosocomiais. A espécie que mais ocasiona doenças em humanos é Aspergillus fumigatus, considerado um agente oportunista, responsável por cerca de 90% dos casos de aspergilose descritos no mundo. As taxas de mortalidade da forma mais grave de aspergilose, a Aspergilose Invasiva (AI), variam entre 80 a 100% em pacientes seriamente imunocomprometidos. A infecção ocasionada por A. fumigatus é diagnosticada por métodos histológicos, cultura e análise macro e micromorfológica, o que limita a identificação no nível de espécie e consequentemente, o correto diagnóstico e tratamento oportuno. A incidência de AI no Brasil é incerta, devido à ausência de dados oficiais de notificação. As investigações conduzidas no país ocorreram em hospitais terciários, mais especificamente em unidades de transplantados (células tronco hematopoiéticas de órgãos sólidos). Dados de resistência a antifúngicos em isolados de A. fumigatus são descritos em coortes europeias e estão correlacionados com falhas terapêuticas. A presente revisão tem como objetivo descrever o impacto da aspergilose ocasionada por A. fumigatus nos dias atuais e a importância do correto diagnóstico laboratorial na prática clínica
Microorganisms of the genus Aspergillus are filamentous, ubiquitous fungi, widely distributed in nature with great importance in agriculture, industry, veterinary medicine and human health, especially as an agent of invasive fungal infection in nosocomial environments. Aspergillus fumigatus, considered an opportunistic agent, accounts for about 90% of the cases of aspergillosis described in the world. Mortality rates of the most severe form of aspergillosis, Invasive Aspergillosis (IA), range from 80 to 100% in severely immunocompromised patients. The infection caused by A. fumigatus is diagnosed by histological methods, culture and macromorphological and micromorphological analysis, which limits the identification at the species level and, consequently, the correct diagnosis and timelytreatment. The incidence of IA in Brazil is uncertain because of the absence of official reporting data. Investigations conducted in thecountry occurred in tertiary hospitals, more specifically in transplant units (hematopoietic stem cells and solid organ). Antifungal resistance data in A. fumigatus isolates are described in european cohorts and are correlated with therapeutic failures. The present reviewaims to describe the impact of aspergillosis caused by A. fumigatus nowadays and the importance of correct laboratory diagnosis in clinical practice
ABSTRACT
Translational medicine and personalized medicine are becoming the new power in modem medical development.Laboratory Developed Tests (LDTs) based on molecular biology and bioinformatics technology play a vital role in the development process of translational medicine and personalized medicine.Nowadays,LDTs consist of a broad range of in vitro diagnositc tests performed to analyze nucleic acid,chromosomes,proteins,certain metabolites and cell surface molecules using immunological technique,cytogenetic or molecular methods or a combination of these methods.These LDTs are used to detect heritable or acquired disease-related genotypes,mutations,or phenotypes,and also used to classify the pathological changes of cells for clinical purposes.New generation LDTs,present some unique regulatory questions still remain to be discussed.Clinicians should capture the opportunity to establish and continuously improve the detection platforms of LDTs,the quality control system and management standards.On this basis,transformation bridges between scientific research and clinical application will be truly built.
ABSTRACT
BACKGROUND: The results of a particular test can be affected by the techniques used for testing. However, limited data is available on the testing techniques used in blood bank laboratories in Korea. The aim of this study was to evaluate the various testing techniques used in blood bank laboratories using the data obtained during the past six years from the Korean external quality assessment (KEQA) of blood bank laboratories. METHODS: Data was collected from all KEQA respondents via the KEQA website on the testing techniques used in blood bank laboratories from 2008 to 2013. The survey included questions on ABO grouping, D typing, crossmatching tests, direct antiglobulin tests (DAT), antibody (Ab) screening, and Ab identification (ID) tests. RESULTS: Based on the data obtained from 2008 to 2013 (ABO grouping data obtained from 2011 to 2013), the most frequently used techniques are as follows: slide agglutination (60.7% and 60.8%) for ABO cell typing; tube agglutination (78.2% and 81.2%) for ABO serum typing; slide agglutination (50% and 54.6%) for D typing; tube agglutination (91.9% and 83.8%) for crossmatching tests; tube agglutination (63.6% and 52.8%) for DAT; column agglutination technique (CAT; 74.5% and 89.4%) for Ab screen; and CAT (83.9% and 94.2%) for Ab ID. CONCLUSIONS: The findings reveal a steady increase in the use of CAT from 2008 to 2013 for crossmatching tests, DAT, Ab screen, and Ab ID and a decreasing use of the tube agglutination technique for the past six years. Since the slide agglutination technique accounted for a significant percentage of the tests conducted, further education is warranted on the improvement in the techniques used for ABO and D typing.