From guesswork to guidelines: advancing diagnostic stewardship in immunocompromised hosts.

IF 3.8 2区医学 Q1 INFECTIOUS DISEASES

Expert Review of Anti-infective Therapy Pub Date : 2025-09-01 Epub Date: 2025-08-18 DOI:10.1080/14787210.2025.2545504

Paul Kinsella, Karin Thursky, Monica A Slavin, Gemma K Reynolds

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引用次数: 0

Abstract

Introduction: Diagnostic stewardship, the optimization of diagnostic testing to improve patient outcomes, is a rapidly evolving field; however, data relating to immunocompromised hosts are scarce.

Areas covered: This review examines recent advances in diagnostic stewardship and explores best practice principles for key clinical scenarios in immunocompromised patients, including febrile neutropenia, central nervous system infections, invasive fungal infections, cytomegalovirus, and Clostridioides difficile infection.

Expert opinion: Key challenges remain, including optimizing test utilization without compromising patient safety, interpreting advanced diagnostics in the context of immunosuppression, and demonstrating cost-effectiveness. A multidisciplinary approach incorporating both diagnostic and antimicrobial stewardship principles is essential to improve outcomes in this complex patient population. Future research should focus on prospective evaluation of diagnostic stewardship interventions and their impact on clinical and economic outcomes in immunocompromised hosts.

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从猜测到指南：推进免疫功能低下宿主的诊断管理。

简介：诊断管理，即优化诊断测试以改善患者预后，是一个快速发展的领域；然而，有关免疫功能低下宿主的数据很少。涵盖领域：本综述审查了诊断管理的最新进展，并探讨了免疫功能低下患者关键临床情况的最佳实践原则，包括发热性中性粒细胞减少症、中枢神经系统感染、侵袭性真菌感染、巨细胞病毒和艰难梭菌。专家意见：主要挑战仍然存在，包括在不影响患者安全的情况下优化检测利用，在免疫抑制的背景下解释先进的诊断，以及证明成本效益。结合诊断和抗菌药物管理原则的多学科方法对于改善这一复杂患者群体的结果至关重要。未来的研究应侧重于诊断管理干预措施的前瞻性评估及其对免疫功能低下宿主的临床和经济结果的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Expert Review of Anti-infective Therapy 医学-药学

CiteScore

11.20

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： Expert Review of Anti-Infective Therapy (ISSN 1478-7210) provides expert reviews on therapeutics and diagnostics in the treatment of infectious disease. Coverage includes antibiotics, drug resistance, drug therapy, infectious disease medicine, antibacterial, antimicrobial, antifungal and antiviral approaches, and diagnostic tests.