Molecular diagnosis of Aspergillus endocarditis after cardiac surgery

Badiee, Parisa; Alborzi, Abdolvahab; Shakiba, Elaheh; Ziyaeyan, Mazyar; Pourabbas, Bahman

doi:10.1099/jmm.0.004531-0

Cited by 22 publications

(15 citation statements)

References 25 publications

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“…In immunocompromised patients, these methods may prove useful if the infection becomes systemic. There are many reports about molecular assays for the detection of systemic fungal infections using punfungal PCR with the available DNA primer sets for the recognition of all fungal species (35), nested PCR (36,37) and real time PCR (38)(39)(40). Molecular assays can serve as a valuable method for the diagnosis of FK in experimental animal infections and patients (41)(42)(43).…”

Section: Diagnosis Of Fungal Keratitismentioning

confidence: 99%

Mycotic Keratitis, a State-of-the-art Review

Badiee

2013

Jundishapur J Microbiol

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Microbial corneal diseases are a serious ocular infection and the major cause of ocular morbidity and blindness in the world. The outcomes of fungal keratitis are unfavorable due to the protracted course of the condition and the diversity of respective clinical presentations. Trauma, contact lens wear, foreign material, and prior corneal surgery, may make the most background for permitting invasion by exogenous fungi by injecting the fungal conidia directly in the corneal stroma. Other risk factors consist of blocked naso-lacrimal duct, and ocular surface disease. More than 105 species of fungi, such as Aspergillus spp., Fusarium spp., Candida spp., Rhizopus, Mucor, and other fungi have been identified as the etiological agents of fungal keratitis. The first step of diagnosis begins with clinical suspicion, followed by corneal scrapings or biopsy for direct smear and culture confirming the etiological agent. Slit lamp biomicroscope is used for careful examination of the infected eye and pictorial documents like the ulcer size, site, depth, extent of infiltration, abscess formation, and any perforation are evaluated. Direct smears are prepared by potassium hydroxide wet mount, or Gram's staining. To identify the isolates, a lactophenol cotton blue wet mount is prepared, and diagnosis is based on morphology of the culture media and details of microscopic examination. The results are highly specific but have suboptimal sensitivity varying in different studies. Molecular assays are valuable for the diagnosis of fungal keratitis in patients. Various advantages and limitations are reported for such methods. Overall, PCR is a sensitive and promising tool for the diagnosis of fungal keratitis but the expertise required and the lack of sophisticated facilities renders it inferior to the smear techniques in routine laboratory procedures and is not recommended accordingly. Rapid diagnosis and proper treatment are essential for fungal keratitis, and many patients require several months of therapy until the infiltrate is resolved and epithelial stroma are healed. Patients not responsive to antifungal therapy usually require corneal transplantation. Keywords: Corneal Ulcer; Keratitis; Eye InfectionsImplication for health policy/ practice/ research/ medical education: Rapid diagnosis andproper treatment are essential for fungal keratitis, and many patients require several months of therapy until the infiltrate is resolved and epithelial stroma is healed. Patients not responsive to antifungal therapy usually require corneal transplantation.

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Section: Diagnosis Of Fungal Keratitismentioning

confidence: 99%

Mycotic Keratitis, a State-of-the-art Review

Badiee

2013

Jundishapur J Microbiol

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“…Few studies have reported on the BDG test in the pediatric population. Several PCR assays to detect Aspergillus DNA have been established [9,10], but few studies have been conducted on the molecular tools for the diagnosis of IA in children.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic potential of nested PCR, galactomannan EIA, and Beta-D-glucan for invasive aspergillosis in pediatric patients

Badiee

Alborzi

Karimi

et al. 2012

J Infect Dev Ctries

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Introduction: Limited specific data and investigations are available for invasive aspergillosis (IA) in pediatric patients. We evaluated the diagnostic potential of three noninvasive tests including the Platelia Aspergillus EIA kit for using galactomannan antigen, (1,3)-β-D-glucan Detection Reagent Kit, and nested-PCR for Aspergillus DNA in sera. We evaluated the diagnostic potential of three noninvasive tests including EIA for galactomannan antigen (Platelia Aspergillus), nested PCR assay for Aspergillus DNA and test for (1→3)-β-D-glucan (Glucatell assay Kit). Methodology: All pediatric patients treated at the hematology/oncology unit who were at increased risk of developing invasive aspergillosis were enrolled. Clinical samples were examined for Aspergillus infections by mycological methods. Serial blood samples were collected twice weekly and evaluated by noninvasive tests. Results: We analyzed 230 consecutive blood samples from 62 pediatric patients. The incidence rate of invasive aspergillosis in the patients was found to be 27.4%, and the etiologic agents were Aspergillus flavus, Aspergillus fumigatus, and Aspergillus spp. The sensitivity, specificity, positive and negative predictive values, and likelihood ratios for positive and negative results of galactomannan in patients with proven and probable IA were 90%, 92%, 81.8%, 96%, 11.25, and 0.1; for beta-D-glucan they were 50%, 46%, 26%, 70.6%, 0.9, 0.9; and for nested-PCR they were 80%, 96.2%, 88.9%, 92.6%, 21, and 0.2, respectively. Conclusions: The conventional methods are not able to detect IA, due to the lack of valid and proper sampling. Galactomannan and nested-PCR tests in serum, with enough accuracy and reliability, can serve as noninvasive methods for the detection of IA in pediatric patients. However, the beta-D-glucan test cannot serve as an efficient diagnostic tool in those with hematologic disorders.

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“…Recent studies have demonstrated that early diagnosis of invasive Aspergillosis can be achieved through the detection of DNA in the samples [16]. The method is suitable for patients with severe underlying diseases because the samples can be obtained noninvasively and easily.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of FK has increased as a result of the frequent use of ocular corticosteroids and the rise in the number of patients who are immunocompromised, and comprises [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35].9% of microbial keratitis [1,2]. Filamentous fungi are the major etiological agents of FK and Aspergillus species are the most common causes of the fungal infection worldwide, especially in tropical climates, reported as 24-30% in some studies [1,3].…”

Section: Introductionmentioning

confidence: 99%

Detection of Aspergillus keratitis in ocular infections by culture and molecular method

2011

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The incidence of fungal keratitis has increased in recent years. Since accurate and rapid diagnosis is important for the proper management of this infection, we evaluated the use of nested PCR to detect Aspergillus-specific DNA in corneal scrapings for the diagnosis of Aspergillus keratitis. From April 2005 to September 2008, patients with eye findings suspicious for fungal keratitis were enrolled for corneal sampling. After ocular examination, we carried out laboratory testing including direct microscopy and culture examination of corneal scrapings, nested PCR and histopathological examination of the corneal tissues obtained at surgery. Of the 57 infected eyes suspicious for fungal keratitis, 32 (56.14%) were reported as Aspergillus keratitis by PCR assay, from which 12 (37.5%) were positive in culture and direct smear for Aspergillus keratitis, and 20 (62.5%) had clinical signs of fungal keratitis (probable). All PCR-positive cases were judged to have fungal infections, based on their responses to the antifungal treatment. The use of molecular methods in high-risk patients can be helpful in diagnosis of fungal infections and can have important public health implications for both the treatment and prevention of suppurative corneal ulcerations. The significance of this study lies in the analysis of the proven cases in terms of both laboratory findings and responses to the treatment.

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Molecular diagnosis of Aspergillus endocarditis after cardiac surgery

Cited by 22 publications

References 25 publications

Mycotic Keratitis, a State-of-the-art Review

Mycotic Keratitis, a State-of-the-art Review

Diagnostic potential of nested PCR, galactomannan EIA, and Beta-D-glucan for invasive aspergillosis in pediatric patients

Detection of Aspergillus keratitis in ocular infections by culture and molecular method

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