Molecular Detection of Invasive Aspergillosis in Hematologic Malignancies

Alborzi

2010

J Infect Dev Ctries

Introduction: Invasive aspergillosis is a severe complication of cytotoxic chemotherapies and bone marrow transplantation (BMT). The aim of this study was to assess the utility of a real-time PCR assay for the early diagnosis of Aspergillus species in blood samples from BMT patients. Methodology: Blood specimens (n = 993) from patients (n = 82) scheduled for BMT were collected prior to transplant and for 100 days post transplantation. The specimens were later tested using an Aspergillus-specific real-time PCR assay. Cultures of clinical samples, along with sonography and computerized tomographic scans, were performed as standard of care. Results: Aspergillus DNA was positive in 94 sequential blood samples from 13 patients with clinical and radiological signs of infection. Samples from three of these patients were PCR-positive for Aspergillus in the first week of admission, prior to transplantation. Four patients with aspergillosis were cured with antifungal agents and nine died. An additional 12 patients without clinical signs of infection were PCRpositive on one occasion each, while two patients with clinical signs of infection were PCR-negative. Compared to routine methods of aspergillosis diagnosis, the respective sensitivity, specificity, negative, and positive predictive values of the PCR method by patient were 86.6%, 82%, 96.5% and 52%. Conclusions: The results show that Aspergillus infections in the blood of bone marrow transplant patients can be dectected by PCR methods. Early detection of Aspergillus infections by PCR has the potential to positively impact patient mortality rate and provide cost savings to hospitals.

Section: Introductionmentioning

confidence: 99%

Detection of Aspergillus species in bone marrow transplant patients

Alborzi

2010

J Infect Dev Ctries

“…The rate of invasive fungal infections is growing parallel with increasing number of immunocompromised patients (29,30). Voriconazole, as an effective agent, is currently used for the treatment of invasive aspergillosis (31).…”

Section: Discussionmentioning

confidence: 99%

Therapeutic Drug Monitoring of Voriconazole: Comparison of Bioassay with High-Performance Liquid Chromatography

Jundishapur J Microbiol

Hashemizadeh

Montaseri

2017

“…There are many reports on the molecular diagnosis of systemic fungal infections (source of endogenous FK) in blood (44)(45)(46) and FK in the eye samples of patients (41,47). The sensitivity rates of molecular methods for the detection of FK were reported to be 81.6% (41), 92.6% (47), and 100% for Aspergillus keratitis by nested PCR assay (30).…”

Section: Molecular Methodsmentioning

confidence: 99%

Management of Fungal Keratitis in Pediatric Patients

Arch Pediatr Infect Dis

Nejabat

Choopanizadeh

2017

Context: Fungal keratitis is an uncommon infection with high morbidity in pediatric patients. Trauma is the most common risk factor for infection in children. Thus, rapid diagnosis should be made by scoring clinical features and mycological examination. This review discusses the management of fungal keratitis in pediatric patients. Evidence Acquisition: In this narrative review, the most recently published data on pediatric fungal keratitis, respective prominent signs and symptoms, etiologic agents, diagnosis and treatment of this infection have been reviewed. Results: Laboratory methods such as investigation of smear by potassium hydroxide and staining and cultural and molecular methods can be helpful in the diagnosis. Treatment of this infection with improved outcome is challenging. Medical therapy (topical and systemic treatments) is the first choice of treatment, but early surgical intervention and removal of the infected tissues are critical for effective cure. Lack of response to these therapies requires corneal transplantation. Unfortunately, loss of useful vision rate was found in patients even with treatment by antifungal agents. Conclusions:The signs and symptoms of fungal keratitis are similar to those of other microbial keratitis. Use of diagnostic methods and early treatment are helpful for recovery in infected pediatric patients.