Document Detail


Rapid Detection and Identification of Mucormycetes in Bronchoalveolar Lavage Samples from Immunocompromised Patients with Pulmonary Infiltrates using High Resolution Melt Analysis.
MedLine Citation:
PMID:  24850354     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Rapid differential diagnostics of pulmonary infiltrates suspected of invasive fungal disease in an immunocompromised host and early initiation of effective antifungal therapy are crucial for patient outcome. There are no serological tests available to detect Mucormycetes and therefore PCR based methods are highly suitable.
METHODS: We validated our previously published PCR followed by high resolution melt analysis (PCR/HRMA) to detect Rhizopus sp., Rhizomucor pusillus, Lichtheimia corymbifera and Mucor sp. in bronchoalveolar lavage (BAL) samples from immunocompromised patients who were at risk of invasive fungal disease All PCR/HRMA positive samples were retested using novel real-time quantitative PCR assays (RQ PCR) specific to the species identified.
RESULTS: In total, between January 2009 and December 2012 we analyzed 99 BAL samples from 86 patients with pulmonary abnormalities using PCR/HRMA. Ninety (91%) BAL samples were negative, 9 (9%) samples were positive. The sensitivity and specificity of PCR/HRMA were 100% and 93%, respectively. By combining the positive result of PCR/HRMA with positive RQ PCR, the specificity was raised to 98%.
CONCLUSIONS: PCR/HRMA due its great negative predictive value (99%) represents a fast and reliable tool for routine BAL sample screening for the differential diagnosis of pulmonary infiltrates in immunocompromised patients for the four most clinically important Mucormycetes.
Authors:
Martina Lengerova; Zdenek Racil; Kristyna Hrncirova; Iva Kocmanova; Pavlina Volfova; Dita Ricna; Petr Bejdak; Mojmir Moulis; Zdenek Pavlovsky; Barbora Weinbergerova; Martina Toskova; Jiri Mayer
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-5-21
Journal Detail:
Title:  Journal of clinical microbiology     Volume:  -     ISSN:  1098-660X     ISO Abbreviation:  J. Clin. Microbiol.     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-5-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7505564     Medline TA:  J Clin Microbiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014, American Society for Microbiology. All Rights Reserved.
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