The future of novel diagnostics in medical mycology

Teles, Fernando; Seixas, Jorge

doi:10.1099/jmm.0.082297-0

Cited by 17 publications

(13 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite their importance to public health, only a small number of antifungal drugs are available to treat dermatophytoses. Regardless of the availability and effectiveness of these drugs, a crucial problem concerning the treatment of fungal infections is the occurrence of resistance, where pathogens overcome host defence mechanisms (Martinez-Rossi et al, 2008;Peres et al, 2010Peres et al, , 2015Teles & Seixas, 2015).…”

Section: Introductionmentioning

confidence: 99%

Compensatory expression of multidrug-resistance genes encoding ABC transporters in dermatophytes

Martins

Franceschini

Jacob

et al. 2016

Journal of Medical Microbiology

View full text Add to dashboard Cite

Genomic sequencing of several dermatophyte species has revealed that they show small differences in genetic content and genome organization, although each fungus has adapted to specific niches. Thus, it seemed relevant to compare gene expression between species. Here, we examined the transcription modulation of three ATP-binding cassette (ABC) transporter genes (pdr1, mdr2 and mdr4), which code for membrane transporter proteins in four species of Trichophyton; T. interdigitale, T. rubrum, T. tonsurans and T. equinum. These fungal species were challenged with sub-lethal doses of griseofulvin, itraconazole, terbinafine and amphotericin B. A mutant strain of T. interdigitale, Dmdr2, was also analysed for the modulation of pdr1 and mdr4 genes to evaluate the possible functional interaction among these three genes. Disruption of the mdr2 gene resulted in the accumulation of high levels of mdr4 transcripts when challenged with griseofulvin, suggesting that the mdr4 gene is compensating for the inactivation of mdr2 by providing resistance to this antifungal. Although the three ABC transporter genes have high homology between the four dermatophytes analysed, it is likely that they have specific functions, suggesting that the action of each drug is dependent on other factors inherent to each species. Our data suggest that these ABC transporter genes act synergistically in dermatophytes, and they may compensate for one another when challenged with antifungal drugs. This may be an important cause of therapeutic failure when treating fungal infections.

show abstract

Section: Introductionmentioning

confidence: 99%

Compensatory expression of multidrug-resistance genes encoding ABC transporters in dermatophytes

Martins

Franceschini

Jacob

et al. 2016

Journal of Medical Microbiology

View full text Add to dashboard Cite

show abstract

“…Pneumocystis jirovecii pneumonia (PjP, formerly PCP) is a fungal infection with potentially severe consequences: mortality rates are still estimated at about 20% . More accurate and rapid diagnosis would allow a prompter initiation of effective antifungal treatment, therefore, substantially reducing subsequent complications . Alternative samples are expected to circumvent the actual limitations of BAL, which is still nowadays the gold‐standard clinical sampling for diagnosis of PjP infection.…”

Section: Discussionmentioning

confidence: 99%

Combination of β‐(1, 3)‐D‐glucan testing in serum and qPCR in nasopharyngeal aspirate for facilitated diagnosis of Pneumocystis jirovecii pneumonia

Désoubeaux

Chesnay

Mercier

et al. 2019

Mycoses

View full text Add to dashboard Cite

Summary Background Currently, the biological diagnosis of Pneumocystis jirovecii pneumonia (PjP infection) usually relies on microbiological investigations in bronchial‐alveolar lavage fluid (BALF) by conventional staining methods and/or molecular biology. However, bronchial‐alveolar lavage is sometimes complicated to manage, especially in weakened patients. Therefore, alternative clinical samples—easier to collect—are warranted in such specific contexts. Objective Over a four‐year period, diagnostic performance of an original method based on combination of quantitative real‐time polymerase chain reaction (qPCR) in nasopharyngeal aspirate (NPA) with measurement of β‐(1, 3)‐D‐glucan antigen (BDG) in serum was prospectively assessed in a single centre. Patients/methods Results were compared with those obtained in BALF through direct staining methods and qPCR. True positives were defined by an independent committee based on clinical, radiological and biological data. Overall, 48 individuals with a definitive diagnosis of PjP infection were included, and 48 controls were selected upon matching for age, sex and underlying disease(s). Results qPCR results were strongly correlated between BALF and NPA (P < .0001). Altogether, greater diagnostic performance was achieved when establishing the positive cut‐off of BDG antigen at 143 pg/mL. In such conditions, sensitivity of the testing based on either positive BDG measurement or positive qPCR in NPA was then calculated at 93.75%, 95%CI [82.37%‐98.40%], and specificity at 97.87%, 95%CI [87.66%‐100.00%]. Conclusions Further validation through multicentre studies is now required, especially for establishing clear cut‐offs. However, one could already state that combination of qPCR in the NPA with BDG measurement in serum may be a valuable substitute for BALF examination.

show abstract

“…These diagnostic techniques are useful for presumptive diagnosis, initiation of antifungal therapy but not for species identification (Teles and Seixas 2015). …”

Section: Laboratory Diagnosismentioning

confidence: 99%

“…Serological techniques can be employed for detection of Candida antigens or antibodies in serum or other body fluids of the patients through immunological or biochemical reactions (Teles and Seixas 2015). These diagnostic techniques are useful for presumptive diagnosis, initiation of antifungal therapy but not for species identification (Teles and Seixas 2015).…”

Section: Laboratory Diagnosismentioning

confidence: 99%