Fungaemia is an increasing nosocomial pathology. The 'gold standard' for detection of fungaemia is blood culture, but it is time-consuming and its sensitivity for early detection is low. On the other hand, yeasts present different antifungal sensitivity patterns to be quickly detected to allow an effective treatment. The aim of this study was to evaluate the diagnostic performances of PNA-FISH to directly identify yeasts from blood cultures and to compare results with those obtained by culture. A total of 176 blood cultures positive for yeasts at direct Gram stain and 24 negative blood cultures as control collected from 15 Italian hospitals, included in a network coordinated by the Medical Mycology Committee, Italian Society of Clinical Microbiology (AMCLI), were examined both by culture and PNA-FISH technology. Sensitivity of the PNA-FISH technique evaluated for five Candida species was 99.3% and specificity, 100%. Distinguishing which yeast is implicated in fungaemia and whether the infection is caused by multiple species are important for the selection of antifungal therapy. The PNA-FISH technique is a very useful approach because the test discriminates between groups of Candida species with different susceptibility pattern, particularly against azoles and echinocandins, with only a 90-minute turn-around time after the Gram-stain reading.
INTRODUZIONELe ARI (Acute Respiratory tract Infections) costituiscono un problema sanitario di grande rilevanza, poiché sono una delle principali cause di morbosità e mortalità a livello mondiale (7). Sono infezioni ubiquitarie, altamente contagiose, trasmissibili per via aerea che colpiscono soggetti di diverse età. Inoltre si possono presentare più volte nell'arco della vita in quanto determinate da una molteplicità di microrganismi. I virus sono di gran lunga gli agenti patogeni più comunemente in causa: attualmente sono noti più di 200 sierotipi, antigenicamente differenti, correlati ad infezioni respiratorie (7,9,15). In base al distretto interessato, alte o basse vie aeree, le infezioni respiratorie possono differenziarsi in URI (Upper Respiratory tract Infections), quali raffreddore, faringite, laringite, tracheite e in LRI (Lower Respiratory tract Infections), come bronchite, bronchiolite e polmonite (9-15). Nelle fascia di età pediatrica, le infezioni respiratorie acute rappresentano una patologia molto comu-
The detection of Aspergillus antigen (galactomannan) is considered a reliable marker for the diagnosis of invasive aspergillosis (IA), yet the sensibility and specificity of the assays commonly employed in routine are not optimal. The aim of the present study was to investigate whether the detection of another panfungal antigen, the (1,3)-b-D-glucan could have an auxiliary role in the identification of patients with IA. The study was carried out on 63 sera belonging to patients who had been screened for galactomannan, according to the clinical suspect of IA. Our data show that the positive galactomannan results were not confirmed by positive (1,3)-b-D-glucan results in patients receiving therapy with beta-lactam antibiotics associated with tazobactam, whereas in all the other cases, with the exception of four, the results of the (1,3)-b-D-glucan test were confirmatory of the galactomannan results.
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