Identification of <i>Mucorales</i> in patients with proven invasive mucormycosis by polymerase chain reaction in tissue samples

Gholinejad-Ghadi, Nahid; Shokohi, Tahereh; Seifi, Zahra; Âghili, Seyed Reza; Roilides, Emmanuel; Nikkhah, Mehdi; Pormosa, Rostam; Karami, Hossein; Larjani, Laleh Vahedi; Ghasemi, Maryam; Haghani, Iman

doi:10.1111/myc.12837

Cited by 37 publications

(42 citation statements)

References 38 publications

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“…8 Quantitative PCR in serum 136,137 or tissue 138,139 are available for some species (e.g., Mucor, Rhizopus, Lichtheimia, Rhizomucor) 136,137,[140][141][142][143][144] and may be superior to culture. [145][146][147][148] Matrix-assisted laser desorption/ionization time of flight is another tool that appears to have a high accuracy for identifying mold from cultures. 149 Next-generation sequencing has the potential to detect IMIs from blood specimens 150 and holds promise for earlier diagnosis of these infections.…”

Section: Diagnosis Changes In Diagnosis and Treatmentmentioning

confidence: 99%

Mucormycosis

Reid

Lynch

Fishbein

et al. 2020

Semin Respir Crit Care Med

151

108

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Mucormycosis is an infection caused by a group of filamentous molds within the order Mucorales. Infections may result from ingestion of contaminated food, inhalation of spores into the nares or lungs, or inoculation into disrupted skin or wounds. In developed countries, mucormycosis occurs primarily in severely immunocompromised hosts (e.g., those with hematological malignancies, organ transplantation, neutropenia, autoimmune disorders, or other impairments in immunity). Only 6 to 10% of cases occur in subjects with no underlying disease. In contrast, in developing countries, most cases of mucormycosis occur in persons with poorly controlled diabetes mellitus or in immunocompetent subjects following trauma. Mucormycosis exhibits a marked propensity to invade blood vessels, leading to thrombosis, necrosis, and infarction of tissue. Mortality associated with invasive mucormycosis is high (> 30–50%), with 90% mortality associated with disseminated disease. Mortality rates are much lower, though still significant (10–30%), among patients with localized cutaneous disease.The diagnosis of mucormycosis relies upon histopathology and culture. Blood tests are of limited diagnostic value. Even with disseminated disease, blood cultures are usually negative. Mucorales have a distinct histological appearance, with irregular, nonseptate hyphae that branch at right angles. Cultures and/or polymerase chain reaction (PCR) are important to identify the genera.Based on anatomic localization, mucormycosis can be classified as one of six forms: (1) rhino-orbital-cerebral mucormycosis (ROCM), (2) pulmonary, (3) cutaneous, (4) gastrointestinal (GI), (5) disseminated, and (6) mucormycosis of uncommon sites. Among diabetics, ROCM is the most common clinical presentation, whereas lung involvement is uncommon. In contrast, among organ transplant recipients or patients with hematological malignancies (HemeM), pulmonary and disseminated diseases are most common. Mucormycosis can progress rapidly, and delay in initiation of treatment by even a few days markedly worsens outcomes.Due to the rarity of mucormycosis, randomized controlled therapeutic trials have not been performed. Lipid formulations of amphotericin B (LFAB) are the mainstay of therapy, but the newer triazoles, posaconazole (POSA) and isavuconazole (ISAV) (the active component of the prodrug isavuconazonium sulfate), may be effective in patients refractory to or intolerant of LFAB. Early surgical debridement or excision plays an important adjunctive role. Additional studies are required to assess the optimal duration of therapy as well as the specific roles of LFAB and the triazoles in the treatment of mucormycosis.

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Section: Diagnosis Changes In Diagnosis and Treatmentmentioning

confidence: 99%

Mucormycosis

Reid

Lynch

Fishbein

et al. 2020

Semin Respir Crit Care Med

151

108

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“…Conventional and real-time PCR assays for the direct detection of minute amounts of Mucorales DNA from fresh or FFPE tissue, BALF, and serum have been reported with the majority targeting the ITS, 18S, or 28S rDNA (Hammond et al, 2011;Millon et al, 2013Millon et al, , 2015Lackner et al, 2014;Springer et al, 2016a,b;Gholinejad-Ghadi et al, 2018). The key to effective molecular diagnosis, however, is efficient DNA extraction from the clinical specimen.…”

Section: Pcr Detection Of Mucormycosismentioning

confidence: 99%

“…The key to effective molecular diagnosis, however, is efficient DNA extraction from the clinical specimen. To date, PCR detection from fresh or FFPE tissue has been the preferred method to identify the causative mucormycete with sensitivities in FFPE tissue of 56-91% (Springer et al, 2016b;Gholinejad-Ghadi et al, 2018). Negative results from FFPE samples may be due to presence of very small amounts of fungal DNA and/or cross-linking of proteins and fragmentation of DNA during formalin fixation (Gholinejad-Ghadi et al, 2018).…”

Section: Pcr Detection Of Mucormycosismentioning

confidence: 99%

A New Age in Molecular Diagnostics for Invasive Fungal Disease: Are We Ready?

et al. 2020

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“…The review included seven studies carried out in 2001-2017 [14][15][16][17][18][19][20] devoted to assessing the effectiveness of molecular methods for the diagnosis of mucormycosis in hematological patients. We analyzed the data from a survey of 116 oncohematological patients with mucormycosis presented in these articles ( Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…In all the works selected for this review, molecular diagnosis of mucormycosis was carried out using the polymerase chain reaction (PCR) method. Four studies used real-time PCR (RT PCR) for 18S rDNA [14][15][16][17]; in two studies, the 18S rDNA region was amplified using endpoint detection [18,19]. One study was based entirely on the determination of the sequence of internal transcribed spacer region (ITS) [20].…”

Section: Resultsmentioning

confidence: 99%

Molecular Diagnostics of Mucormycosis in Hematological Patients: A Literature Review

Шадривова

Burygina

Климко

2019

JoF

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Objectives: to analyze the results of molecular methods applying for the diagnosis of mucormycosis in hematologic patients based on a literature review. Data sources: A systematic search in databases PubMed, Google Scholar for August 2019. Review eligibility criteria: original articles published in English, studies of molecular methods for the diagnosis of mucormycosis in hematologic patients. Results. We analyzed the research data from 116 hematological patients with mucormycosis, including children (6%). Patients with localized forms of mucormycosis prevailed (72%), and lung involvement was diagnosed in 58% of these cases. For molecular verification of the causative agent of mucormycosis, blood serum was most often used, less commonly postoperative and autopsy material, biopsy specimens, formalin-fixed paraffin-embedded samples and bronchoalveolar lavage, pleural fluid and sputum. The sensitivity of molecular diagnostics of mucormycosis in a cohort of hematological patients was 88.2%. Conclusion. The use of molecular techniques along with standard mycological methods will improve the diagnostics of mucormycosis in hematologic patients. However, prospective studies of the effectiveness of molecular methods for the diagnosis of mucormycosis of various etiologies in hematological patients, including children, using bronchoalveolar lavage (BAL) and cerebrospinal fluid (CSF) are needed.

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Identification of Mucorales in patients with proven invasive mucormycosis by polymerase chain reaction in tissue samples

Abstract: Seminested PCR targeting 18S rDNA region of Mucorales is useful for identification of the causative agents of mucormycosis.

Cited by 37 publications

References 38 publications

Mucormycosis

Mucormycosis

A New Age in Molecular Diagnostics for Invasive Fungal Disease: Are We Ready?

Molecular Diagnostics of Mucormycosis in Hematological Patients: A Literature Review

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