Application of Mass Spectrometry Technology to Early Diagnosis of Invasive Fungal Infections
نویسندگان
چکیده
We recently developed a mass spectrometry (MS) procedure based on the detection of a serum disaccharide (MS-DS) in patients with invasive candidiasis (IC). Here, we compare the performance of MS-DS for the diagnosis of IC, invasive aspergillosis (IA), and mucormycosis (MM) with those of commercially available antigen detection tests. This retrospective study included 48 patients (23 IC patients [74 serum samples], 15 IA patients [40 serum samples], and 10 MM patients [15 serum samples]) and 49 appropriate controls (102 serum samples). MS-DS, mannan (Mnn), galactomannan (GM), and (1,3)-β-d-glucan (BDG) were detected by matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) MS, Platelia, and Fungitell assays, respectively. For IC, the sensitivity and specificity of the MS-DS index, BDG detection, and Mnn detection were 62% and 84%, 82% and 60%, and 33% and 94% per serum sample and 83% and 69%, 96% and 31%, and 39% and 86% per patient, respectively. For IA, the corresponding values in comparison to BDG and GM detection were 83% and 81%, 62% and 95%, and 62% and 100% per serum sample and 93% and 76%, 87% and 90%, and 93% and 100% per patient, respectively. Nine of the 10 MM patients had a positive MS-DS result. MS-DS gave an early diagnosis in IC (73% positivity before blood culture), IA (positive before GM detection in six patients), and MM (positivity mainly preceded the date of diagnosis) patients. For IC, persisting MS-DS was associated with a poor prognosis. The different biomarkers were rarely detected simultaneously, suggesting different kinetics of release and clearance. For IA, MS-DS provided better complementation to GM monitoring than BDG monitoring. MS-DS detects panfungal molecules circulating during invasive fungal infections. The performance of MS-DS compared favorably with those of biological tests currently recommended for monitoring at-risk patients. Further validation of this test in multicenter studies is required.
منابع مشابه
Invasive Aspergillosis in COVID-19: A Review Study and Recommendations for Diagnostic Approaches
Background and purpose: COVID-19 is an emerging viral disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Bacterial or fungal superinfections of the lung may cause complications in clinical manifestations, treatment, and increase the mortality rate. In this article, we reviewed previous studies on invasive aspergillosis (IA) in viral infections and in adjustment with...
متن کاملRNAi technology: A Novel approaches against fungal infections
Despite the introduction of new antifungal agents, resistances to antifungal therapy continue to increase and outcome of invasive fungal infections treatment is frequently suboptimal. A large amount of the recent effort in antifungal drug discovery has focused on a limited set of targets with functions known or expected to be important for fungal viability and virulence. A variety of techniques...
متن کاملمروری بر عفونت قارچی در بیماران سوختگی، تشخیص و درمان
Burn wound is a suitable environment for growth and reproduction of microorganisms. The tissue in the burn wounds is not live and do not have blood vessels so, polymorphonuclear antibodies and systemic antibiotics cannot diffuse into it. Thus, the condition of the wound is provided for the growth of bacteria and opportunistic fungi such as Candida, Mucor, Rhizopus, Penicillium, and Aspergillus....
متن کاملBiomarker-guided antifungal stewardship policies for patients with invasive candidiasis
Invasive fungal infections (IFIs) are among the life-threatening issues in patients with impaired immune system. High administration of antifungals in these patients imposes a heavy economic burden on the national health system. In addition, despite the usually expensive antifungal regimens, the mortality rate due to fungal infections is still high, resulting in the loss of hundreds of lives pe...
متن کاملApplication of Real-Time PCR to the Diagnosis of Invasive Fungal Infection
The management of invasive fungal infections has been hampered by the inability to make a diagnosis at an early stage of the disease. Molecular diagnosis by PCR appears very promising since fungal DNA can be detected in the blood of infected patients earlier than when using conventional methods. Recently, interest in the diagnosis of invasive fungal infections by real-time PCR has increased. Re...
متن کامل