Identification of invasive fungal diseases in immunocompromised patients by combining an Aspergillus specific PCR with a multifungal DNA-microarray from primary clinical samples

Summary The increasing incidence of invasive fungal diseases (IFD), most of all invasive aspergillosis (IA) in immunocompromised patients emphasises the need to improve the diagnostic tools for detection of fungal pathogens. We investigated the diagnostic performance of a multifungal DNA‐microarray...

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Bibliographic Details
Published in:	Mycoses Vol. 58; no. 12; pp. 735 - 745
Main Authors:	Boch, T., Reinwald, M., Postina, P., Cornely, O. A., Vehreschild, J. J., Heußel, C. P., Heinz, W. J., Hoenigl, M., Eigl, S., Lehrnbecher, T., Hahn, J., Claus, B., Lauten, M., Egerer, G., Müller, M. C., Will, S., Merker, N., Hofmann, W.-K., Buchheidt, D., Spiess, B.
Format:	Journal Article
Language:	English
Published:	Germany Blackwell Publishing Ltd 01-12-2015
Subjects:	Adult Antifungal Agents - therapeutic use Aspergillosis - blood Aspergillosis - diagnosis Aspergillosis - diagnostic imaging Aspergillus Aspergillus fumigatus - genetics Aspergillus fumigatus - immunology Aspergillus fumigatus - isolation & purification Base Sequence Biopsy, Needle Bronchoalveolar Lavage Candida clinical samples DNA, Fungal - isolation & purification DNA-microarray Female Fusarium Humans Immunocompromised Host invasive fungal disease Male Molecular Sequence Data Mucor multiplex fungal PCR Multiplex Polymerase Chain Reaction - methods Oligonucleotide Array Sequence Analysis - methods Radiography Rhizopus Scedosporium Sensitivity and Specificity Trichosporon DNA-microarray invasive fungal disease multiplex fungal PCR clinical samples
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Summary:	Summary The increasing incidence of invasive fungal diseases (IFD), most of all invasive aspergillosis (IA) in immunocompromised patients emphasises the need to improve the diagnostic tools for detection of fungal pathogens. We investigated the diagnostic performance of a multifungal DNA‐microarray detecting 15 different fungi [Aspergillus, Candida, Fusarium, Mucor, Rhizopus, Scedosporium and Trichosporon species (spp.)] in addition to an Aspergillus specific polymerase chain reaction (PCR) assay. Biopsies, bronchoalveolar lavage and peripheral blood samples of 133 immunocompromised patients (pts) were investigated by a multifungal DNA‐microarray as well as a nested Aspergillus specific PCR assay. Patients had proven (n = 18), probable (n = 29), possible (n = 48) and no IFD (n = 38) and were mostly under antifungal therapy at the time of sampling. The results were compared to culture, histopathology, imaging and serology, respectively. For the non‐Aspergillus IFD the microarray analysis yielded in all samples a sensitivity of 64% and a specificity of 80%. Best results for the detection of all IFD were achieved by combining DNA‐microarray and Aspergillus specific PCR in biopsy samples (sensitivity 79%; specificity 71%). The molecular assays in combination identify genomic DNA of fungal pathogens and may improve identification of causative pathogens of IFD and help overcoming the diagnostic uncertainty of culture and/or histopathology findings, even during antifungal therapy.
Bibliography:	istex:CB8EA6792DAEAA9613E195AD1A9C7252EE6EF762 ark:/67375/WNG-16JSD7MW-N ArticleID:MYC12424 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0933-7407 1439-0507
DOI:	10.1111/myc.12424