Study on invasive fungal infections in immunocompromised patients to present a suitable early diagnostic procedure

Badiee, Parisa; Kordbacheh, Parivash; Alborzi, Abdolvahab; Malekhoseini, SeyedAli; Ramzi, Mani; Mirhendi, H; Mahmoodi, Mahmood; Shakiba, Elaheh

doi:10.1016/j.ijid.2008.04.011

Cited by 36 publications

(16 citation statements)

References 27 publications

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“…In the present study, three patients had Aspergillus DNA in their blood samples prior to transplantation with no clinical criteria; only one patient survived. Other studies reported that molecular methods can help detect the fungal infections before clinical findings [23,24]. Our data show that fungal DNA can be identified prior to clinical manifestations in patients with hematological disorders, who received multiple chemotherapy and steroid treatments, and who were neutropenic at different stages of their sicknesses.…”

Section: Discussionmentioning

confidence: 57%

Detection of Aspergillus species in bone marrow transplant patients

Badiee

Alborzi

2010

J Infect Dev Ctries

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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.

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Section: Discussionmentioning

confidence: 57%

Detection of Aspergillus species in bone marrow transplant patients

Badiee

Alborzi

2010

J Infect Dev Ctries

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“…In such cases, PCR facilitates species identification, which cannot be achieved through microscopy but can serve an important role in guiding antifungal therapy. Multiplex PCR has also been tested as a method to detect fungal species in whole-blood (236,238,(243)(244)(245), serum (246), or BAL fluid (247) samples from patients at high risk for IFIs. The results are variable, but most studies report superior sensitivities and specificities of Ͼ80% (236,238,243,248).…”

Section: Pcrmentioning

confidence: 99%

Molecular and Nonmolecular Diagnostic Methods for Invasive Fungal Infections

et al. 2014

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SUMMARY Invasive fungal infections constitute a serious threat to an ever-growing population of immunocompromised individuals and other individuals at risk. Traditional diagnostic methods, such as histopathology and culture, which are still considered the gold standards, have low sensitivity, which underscores the need for the development of new means of detecting fungal infectious agents. Indeed, novel serologic and molecular techniques have been developed and are currently under clinical evaluation. Tests like the galactomannan antigen test for aspergillosis and the β-glucan test for invasive Candida spp. and molds, as well as other antigen and antibody tests, for Cryptococcus spp., Pneumocystis spp., and dimorphic fungi, have already been established as important diagnostic approaches and are implemented in routine clinical practice. On the other hand, PCR and other molecular approaches, such as matrix-assisted laser desorption ionization (MALDI) and fluorescence in situ hybridization (FISH), have proved promising in clinical trials but still need to undergo standardization before their clinical use can become widespread. The purpose of this review is to highlight the different diagnostic approaches that are currently utilized or under development for invasive fungal infections and to identify their performance characteristics and the challenges associated with their use.

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“…Badiee New methods for the identification of fungi, although still not widely available, include immunofluorescence staining, electron microscopy and polymerase chain reaction (PCR). The potential utility of PCR-based techniques for improving the diagnosis of infections is well recognized, and the use of PCR for this purpose is expanding [7][8][9][10][11] . PCR assays targeting Candida , Aspergillus and Fusarium have been tested preliminarily in vitreous specimens [8,9] .…”

Section: Introductionmentioning

confidence: 99%

Comparative Study of Gram Stain, Potassium Hydroxide Smear, Culture and Nested PCR in the Diagnosis of Fungal Keratitis

Badiee¹,

Nejabat

Alborzi³

et al. 2010

Ophthalmic Res

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Objective: This study seeks to evaluate the efficacy and practicality of the molecular method, compared to the standard microbiological techniques for diagnosing fungal keratitis (FK). Methods: Patients with eye findings suspected of FK were enrolled for cornea sampling. Scrapings from the affected areas of the infected corneas were obtained and were divided into two parts: one for smears and cultures, and the other for nested PCR analysis. Results: Of the 38 eyes, 28 were judged to have fungal infections based on clinical and positive findings in the culture, smear and responses to antifungal treatment. Potassium hydroxide, Gram staining, culture and nested PCR results (either positive or negative) matched in 76.3, 42.1, 68.4 and 81.6%, respectively. Conclusion: PCR is a sensitive method but due to the lack of sophisticated facilities in routine laboratory procedures, it can serve only complementarily and cannot replace conventional methods.

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Study on invasive fungal infections in immunocompromised patients to present a suitable early diagnostic procedure

Abstract: It may be concluded that the molecular assay would help in the diagnosis of invasive fungal infections at the early stage of infection, before clinical manifestations.

Cited by 36 publications

References 27 publications

Detection of Aspergillus species in bone marrow transplant patients

Detection of Aspergillus species in bone marrow transplant patients

Molecular and Nonmolecular Diagnostic Methods for Invasive Fungal Infections

Comparative Study of Gram Stain, Potassium Hydroxide Smear, Culture and Nested PCR in the Diagnosis of Fungal Keratitis

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