Quantitative Polymerase Chain Reaction Detection of Circulating DNA in Serum for Early Diagnosis of Mucormycosis in Immunocompromised Patients
Open Access
- 18 February 2013
- journal article
- research article
- Published by Oxford University Press (OUP) in Clinical Infectious Diseases
- Vol. 56 (10), e95-e101
- https://doi.org/10.1093/cid/cit094
Abstract
Background. The aim of our study was to assess the detection of circulating DNA from the most common species of Mucorales for early diagnosis of mucormycosis in at-risk patients. Methods. We retrospectively evaluated a combination of 3 quantitative polymerase chain reaction (qPCR) assays using hydrolysis probes targeting Mucor/Rhizopus, Lichtheimia (formerly Absidia), and Rhizomucor for circulating Mucorales detection. Serial serum samples from 10 patients diagnosed with proven mucormycosis (2–9 samples per patient) were analyzed. Results. No cross-reactivity was detected in the 3 qPCR assays using 19 reference strains of opportunistic fungi, and the limit of detection ranged from 3.7 to 15 femtograms/10 µL, depending on the species. DNA from Mucorales was detected in the serum of 9 of 10 patients between 68 and 3 days before mucormycosis diagnosis was confirmed by histopathological examination and/or positive culture. All the qPCR results were concordant with culture and/or PCR-based identification of the causing agents in tissue (Lichtheimia species, Rhizomucor species, and Mucor/Rhizopus species in 4, 3, and 2 patients, respectively). Quantitative PCR was negative in only 1 patient with proven disseminated mucormycosis caused by Lichtheimia species. Conclusion. Our study suggests that using specific qPCR targeting several species of Mucorales according to local ecology to screen at-risk patients could be useful in a clinical setting. The cost and efficacy of this strategy should be evaluated. However, given the human and economic cost of mucormycosis and the need for rapid diagnosis to initiate prompt directed antifungal therapy, this strategy could be highly attractive.Keywords
This publication has 24 references indexed in Scilit:
- Future Directions in Mucormycosis ResearchClinical Infectious Diseases, 2012
- A Global Analysis of Mucormycosis in France: The RetroZygo Study (2005-2007)Clinical Infectious Diseases, 2012
- The emerging epidemiology of mould infections in developing countriesCurrent Opinion in Infectious Diseases, 2011
- Invasive Non-AspergillusMold Infections in Transplant Recipients, United States, 2001–2006Emerging Infectious Diseases, 2011
- Molecular Methods To Improve Diagnosis and Identification of MucormycosisJournal of Clinical Microbiology, 2011
- Mycoses of implantation in Latin America: an overview of epidemiology, clinical manifestations, diagnosis and treatmentMedical Mycology, 2011
- Increasing Incidence of Mucormycosis in University Hospital, BelgiumEmerging Infectious Diseases, 2010
- Increasing Incidence of Zygomycosis (Mucormycosis), France, 1997–2006Emerging Infectious Diseases, 2009
- Detection of a Molecular Biomarker for Zygomycetes by Quantitative PCR Assays of Plasma, Bronchoalveolar Lavage, and Lung Tissue in a Rabbit Model of Experimental Pulmonary ZygomycosisJournal of Clinical Microbiology, 2008
- Diagnosis of invasive aspergillosis and mucormycosis in immunocompromised patients by seminested PCR assay of tissue samplesEuropean Journal of Clinical Microbiology & Infectious Diseases, 2006