Breath-Based Diagnosis of Invasive Mucormycosis (IM)

Koshy, Seena; Ismail, Nour; Astudillo, Carmen Leon; Haeger, Christina Mallarino; Aloum, Obadah; Acharige, Mahesh Thalavitiya; Farmakiotis, Dimitrios; Baden, Lindsey R.; Marty, Francisco M.; Kontoyiannis, Dimitrios P.; Fredenburgh, L.E.; Koo, Sophia

doi:10.1093/ofid/ofx162.124

Cited by 22 publications

(14 citation statements)

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“…arrhizus , R. arrhizus var. delemar and R. microsporus , by thermal desorption gas chromatography/tandem mass spectrometry (GC–MS) [ 126 ]. Mice infected with Aspergillus fumigatus were used as controls.…”

Section: Diagnosismentioning

confidence: 99%

Epidemiology and Diagnosis of Mucormycosis: An Update

Skiada

Pavleas

Drogari‐Apiranthitou

2020

JoF

519

508

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Mucormycosis is an angioinvasive fungal infection, due to fungi of the order Mucorales. Its incidence cannot be measured exactly, since there are few population-based studies, but multiple studies have shown that it is increasing. The prevalence of mucormycosis in India is about 80 times the prevalence in developed countries, being approximately 0.14 cases per 1000 population. Diabetes mellitus is the main underlying disease globally, especially in low and middle-income countries. In developed countries the most common underlying diseases are hematological malignancies and transplantation. Τhe epidemiology of mucormycosis is evolving as new immunomodulating agents are used in the treatment of cancer and autoimmune diseases, and as the modern diagnostic tools lead to the identification of previously uncommon genera/species such as Apophysomyces or Saksenaea complex. In addition, new risk factors are reported from Asia, including post-pulmonary tuberculosis and chronic kidney disease. New emerging species include Rhizopus homothallicus, Thamnostylum lucknowense, Mucor irregularis and Saksenaea erythrospora. Diagnosis of mucormycosis remains challenging. Clinical approach to diagnosis has a low sensitivity and specificity, it helps however in raising suspicion and prompting the initiation of laboratory testing. Histopathology, direct examination and culture remain essential tools, although the molecular methods are improving. The internal transcribed spacer (ITS) region is the most widely sequenced DNA region for fungi and it is recommended as a first-line method for species identification of Mucorales. New molecular platforms are being investigated and new fungal genetic targets are being explored. Molecular-based methods have gained acceptance for confirmation of the infection when applied on tissues. Methods on the detection of Mucorales DNA in blood have shown promising results for earlier and rapid diagnosis and could be used as screening tests in high-risk patients, but have to be validated in clinical studies. More, much needed, rapid methods that do not require invasive procedures, such as serology-based point-of-care, or metabolomics-based breath tests, are being developed and hopefully will be evaluated in the near future.

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Section: Diagnosismentioning

confidence: 99%

Epidemiology and Diagnosis of Mucormycosis: An Update

Skiada

Pavleas

Drogari‐Apiranthitou

2020

JoF

519

508

View full text Add to dashboard Cite

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“…arrhizus , R. arrhizus var. delemar, and R. microsporus [ 78 ]. The volatile metabolite sesquiterpene displayed distinct breath profiles and distinguished mucormycosis from aspergillosis.…”

Section: Dna-based Diagnosismentioning

confidence: 99%

Microbiological and Molecular Diagnosis of Mucormycosis: From Old to New

2021

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Members of the order Mucorales may cause severe invasive fungal infections (mucormycosis) in immune-compromised and otherwise ill patients. Diagnosis of Mucorales infections and discrimination from other filamentous fungi are crucial for correct management. Here, we present an overview of current state-of-the-art mucormycosis diagnoses, with a focus on recent developments in the molecular field. Classical diagnostic methods comprise histology/microscopy as well as culture and are still the gold standard. Newer molecular methods are evolving quickly and display great potential in early diagnosis, although standardization is still missing. Among them, quantitative PCR assays with or without melt curve analysis are most widely used to detect fungal DNA in clinical samples. Depending on the respective assay, sequencing of the resulting PCR product can be necessary for genus or even species identification. Further, DNA-based methods include microarrays and PCR-ESI-MS. However, general laboratory standards are still in development, meaning that molecular methods are currently limited to add-on analytics to culture and microscopy.

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“…The relationship between metabolite signature and nodule size, the kinetics of these metabolites with antifungal therapy, and distinguishing between colonization versus infection are all areas of potential exploration [ 135 ]. This technology could be applied for the detection of other pathogenic molds and endemic fungi [ 136 ].…”

Section: Aspergillusmentioning

confidence: 99%