Comparison of serum PCR assay and histopathology for the diagnosis of invasive aspergillosis and mucormycosis in immunocompromised patients with sinus involvement

Shokouhi, Shervin; Mirzaei, Jamal; Sajadi, Mohammad M.; Javadi, Alireza

doi:10.18869/acadpub.cmm.2.4.46

Cited by 7 publications

(6 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…11 Although previous studies have evaluated the diagnostic usefulness of blood PCR in patients with invasive aspergillosis or mucormycosis, 4,[12][13][14] there are limited data on the differential diagnosis of invasive aspergillosis and mucormycosis by using blood fungal PCR in patients with suspected invasive mould infections. 15,16 In In our study, blood PCR invasive aspergillosis showed lower sensitivity and higher specificity than in previous studies. TA B L E 2 (Continued) specificity of 75-76%.…”

Section: Discussioncontrasting

confidence: 47%

“…In this context, this study provides important data on the usefulness of fungal PCR for the differential diagnosis of invasive mould infections to the current fungal PCR literature. Shokouhi et al reported that serum PCR was as an unreliable tool for diagnosing immunocompromised patients with suspected fungal sinus infection, showing negative results for all 31 serum samples with sensitivities of 1.3 ng and 12 pg for mucormycosis and aspergillosis, respectively 16 . However, our finding suggests that blood PCR may be useful in a clinical setting in which biopsy is not feasible, or in which morphologic or sparse fungal elements have limited the interpretation of histologic findings.…”

Section: Discussionmentioning

confidence: 57%

“…Our previous study demonstrated that voriconazole use is a risk factor for mortality in pulmonary mucormycosis 11 . Although previous studies have evaluated the diagnostic usefulness of blood PCR in patients with invasive aspergillosis or mucormycosis, 4,12–14 there are limited data on the differential diagnosis of invasive aspergillosis and mucormycosis by using blood fungal PCR in patients with suspected invasive mould infections 15,16 . In this context, this study provides important data on the usefulness of fungal PCR for the differential diagnosis of invasive mould infections to the current fungal PCR literature.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Diagnostic performance of real‐time polymerase chain reaction assay on blood for invasive aspergillosis and mucormycosis

Seo

Kim

Son

et al. 2021

Mycoses

View full text Add to dashboard Cite

Objectives: This study aimed to evaluate the diagnostic usefulness of real-time (RT) polymerase chain reaction (PCR) on blood samples for diagnosis of invasive aspergillosis and mucormycosis in patients with suspected invasive mould infection.Methods: Adult patients with suspected invasive mould infection were prospectively enrolled at a tertiary referral hospital in Seoul, South Korea between 2017 and 2020. Standard tests for diagnosis of invasive mould infection and RT-PCR for Aspergillus,Mucor and Rhizopus using blood samples were performed. We evaluated the diagnostic performance of RT-PCR tests in patients diagnosed with proven and probable invasive aspergillosis or mucormycosis infection, according to the modified definitions of the EORTC/MSG 2019.Results: A total of 102 patients with suspected invasive mould infection were enrolled. Of these patients, 46 (45%) were classified as having proven (n = 13) or probable (n = 33) invasive aspergillosis, 21 (21%) as proven (n = 17) or probable (n = 4) invasive mucormycosis and 18 (18%) as possible invasive mould infection. The remaining 13 (13%) were classified as not having invasive mould infection. Patients with possible invasive mould infection (n = 18) and coinfection of aspergillosis and mucormycosis (n = 4) were excluded from the final analysis. The sensitivity and specificity of the Aspergillus PCR were 54.3% ([25/46], 95% confidence interval [CI]: 40.2-67.9%) and 94.1% ([32/34], 95% CI: 80.9-98.4%), respectively. The sensitivity and specificity of the Mucor or Rhizopus PCR were 57.1% ([12/21], 95% CI: 36.6-75.5%) and 76.3% ([45/59], 95% CI: 64.0-85.3), respectively.Conclusions: Our study suggests that blood PCR can be a useful adjunct test for diagnosing patients with suspected invasive mould infection.

show abstract

Section: Discussioncontrasting

confidence: 47%

Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Diagnostic performance of real‐time polymerase chain reaction assay on blood for invasive aspergillosis and mucormycosis

Seo

Kim

Son

et al. 2021

Mycoses

View full text Add to dashboard Cite

show abstract

“…The clinical manifestation and duration of the illness depend on host’s immune status and vary from innocuous and slight presentation to alive threatening complications [ 6 ]. Because of the growing prevalence of chemotherapy, human immunodeficiency virus (HIV) infections, and diabetes mellitus, the number of susceptible immune-compromised hosts is expanding [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Identification of fungal causative agents of rhinosinusitis from Mashhad, Iran

et al. 2017

View full text Add to dashboard Cite

Background and Purpose:Rhinosinusitis is a common disorder, influencing approximately 20% of the population at some time of their lives. It was recognized and reported with expanding recurrence over the past two decades worldwide. Undoubtedly, correct diagnosis of fungi in patients with fungal rhinosinusitis affects the treatment planning and prognosis of the patients. Identification of the causative agents using the standard mycological procedures remains difficult and time-consuming.Materials and Methods:Based on clinical and radiological parameters, 106 patients suspected of fungal rhinosinusitis were investigated in this cross-sectional prospective study from April 2012 to March 2016 at an otorhinolaryngology department. In this study, internal transcribed spacer (ITS) and calmodulin (CaM) sequencing were respectively validated as reliable techniques for the identification of Mucorales and Aspergillus to species level (both agents of fungal rhinosinusitis).Results:Of these, 63 (59.4%) patients were suspected of allergic fungal rhinosinusitis (AFRS), 40 (37.7%) patients suspected of acute invasive fungal rhinosinusitis (AIFRS), and 3 (2.8%) patients suspected of mycetoma. In patients suspected of AFRS, AIFRS, and mycetoma only 7, 29, and 1 had positive fungal culture, respectively. After ITS and CaM sequencing, Aspergillus flavus was the most common species isolated from non-invasive forms, and A. flavus and Rhizopus oryzae were more frequently isolated from invasive forms.Conclusion: A spergillus flavus is the most common agent of fungal rhinosinusitis in Iran, unlike most other reports from throughout the world stating that A. fumigatus is the most frequent causative agent of this disease.

show abstract

“…However, decreased sensitivity of galactomannan antigen assay is observed in patients with anti-mold therapy [115]. In addition, Aspergillus PCR from blood and BAL fluid is introduced to confirm the diagnosis and identify specific Aspergillus species with certain mutations related to triazole resistance [109,[116][117][118][119][120][121][122][123][124]. Nonetheless, revised EORTC/MSG criteria for diagnosing invasive fungal infections may be applied mainly for neutropenic patients or immunocompromised patients.…”

Section: Diagnosis Of Invasive Aspergillus Infections: Challenge In the Fieldmentioning

confidence: 99%

Aspergillus-Human Interactions: From the Environment to Clinical Significance

Thammahong¹

2022

The Genus Aspergillus - Pathogenicity, Mycotoxin Production and Industrial Applications

View full text Add to dashboard Cite

Aspergillus species are ubiquitous fungi found in the environment worldwide. The most common Aspergillus species causing diseases in humans are A. fumigatus, A. flavus, A. niger, and A. terreus. However, species causing human infections are also depending on human immune status. Host immune status and previous underlying diseases are important factors leading to different clinical manifestations and different disease spectra of Aspergillus infections. The most severe form of Aspergillus infections is invasive aspergillosis in human tissue, especially invasive pulmonary aspergillosis (IPA), which has high morbidity and mortality in immunocompromised patients. ICU patients with influenza infections and COVID-19 infections are recently risk factors of invasive pulmonary aspergillosis. New diagnostic criteria include galactomannan antigen assays, nucleic acid amplification assays, and lateral flow assays for early and accurate diagnosis. Voriconazole and the newest azole, isavuconazole, are antifungals of choice in IPA. Nevertheless, azole-resistant Aspergillus strains are increasing throughout the world. The etiology and spreading of azole-resistant Aspergillus strains may originate from the widespread use of fungicides in agriculture, leading to the selective pressure of azole-resistant strains. Therefore, there is a necessity to screen Aspergillus antifungal susceptibility patterns for choosing an appropriate antifungal agent to treat these invasive infections. In addition, mutations in an ergosterol-producing enzyme, i.e., lanosterol 14-α demethylase, could lead to azole-resistant strains. As a result, the detection of these mutations would predict the resistance to azole agents. Although many novel azole agents have been developed for invasive Aspergillus infections, the rate of novel antifungal discovery is still limited. Therefore, better diagnostic criteria and extensive antifungal resistant Aspergillus screening would guide us to better manage invasive Aspergillus infections with our existing limited resources.

show abstract

Comparison of serum PCR assay and histopathology for the diagnosis of invasive aspergillosis and mucormycosis in immunocompromised patients with sinus involvement

Cited by 7 publications

References 18 publications

Diagnostic performance of real‐time polymerase chain reaction assay on blood for invasive aspergillosis and mucormycosis

Diagnostic performance of real‐time polymerase chain reaction assay on blood for invasive aspergillosis and mucormycosis

Identification of fungal causative agents of rhinosinusitis from Mashhad, Iran

Aspergillus-Human Interactions: From the Environment to Clinical Significance

Contact Info

Product

Resources

About