مروری بر آسپرژیلوزیس تهاجمی در بیماران بستری شده در بخش مراقبت های ویژه با تاکید بر روش های تشخیصی

The genus Aspergillus is ubiquitous filamentous fungi with a wide distribution in nature. The species of Aspergillus are associated with a varied spectrum of diseases including allergy, superficial colonization and invasive infection in humans. Invasive aspergillosis (IA) is a serious and fulminate mycosis in immuno-deficient individuals. Over the last decade, IA has also been reported as a fungal infection in critically ill patients, admitted to ICU with high morbidity and mortality rate. However, long term admission in ICU, treatment with immuno-suppressive agents caused by increasing incidence of IA in the ICU. It is expressed that delay in proper diagnosis, no timely treatment and the presence of different underlying diseases and neutropenia are the important reasons of high mortality in these patients. In spite of advances in diagnosis and treatment of IA, it appears that the occurrence of IA in ICU patients is due to lack of estimation and proper diagnosis of disease. In addition to traditional methods, using the specialized methods such as PCR, evaluation of serological markers including Galactomanan and β-D Glucan in different types of specimens, is necessary to show the true rate of IA risk in ICU patients and also to have a proper program for hygienic and preventive actions. Along with the increase in the number of ICU units comes a surge in admission of patients in these centers, but because there was no such study in Iran, we reviewed the papers in this field to consider different aspects of IA with emphasis on diagnostic methods.