Molecular Diagnosis of Endemic Mycoses

Valero, Clara; Martín-Gómez, María Teresa; Buitrago, María J.

doi:10.3390/jof9010059

Cited by 4 publications

(8 citation statements)

References 117 publications

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“…In view of this, in the absence of routine fungal culture, proceeding with further molecular investigations on tissue blocks in which histopathology analysis demonstrated the presence of fungal elements will go a long way to influence drug options while providing data on emerging or rare species causing human infections. 19 , 20 This is extremely important in the Ghanaian clinical setting particularly considering the critical role of histopathology in aiding diagnosis and in most instances the commonly available means of diagnosis. 4 Despite the common use of molecular methods on formalin-fixed-paraffin-embedded to aid species-level identification in many clinical mycology laboratories, the methodology or procedures of available assays are not extensively standardized and not available in many African settings.…”

Section: Discussionmentioning

confidence: 99%

A diverse spectrum of mycoses histologically diagnosed in Ghana: Insights from a 10-year retrospective study

Ocansey,

Erskine,

Okine

et al. 2024

Medical Mycology

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In Ghana, most laboratory diagnosis of severe mycoses are based on histopathology findings due to inadequate availability of serology, culture, and molecular tests. The aim of this study was to evaluate the spectrum of mycoses diagnosed in Ghana. We retrospectively reviewed reports from 2012 to 2021 from three major pathology laboratories in Ghana to identify reports indicating the presence of fungal elements and diagnosis of a mycosis, then extracted demographic, clinical history, site of infection, stain (s) used and diagnosed mycosis details. Over the 10-year period, 107 cases were found. No apparent increasing and decreasing trend of the number of cases per year or in a period was observed. The age range of affected patients were from 4 to 86 years. Special stains for fungi were only used in 22 of 107 (20.6%) of cases. The most frequently affected site was the sino-nasal area (34%). Mycosis type was determined for 58 (54.2%) cases, comprising aspergillosis (21), candidiasis (14), dermatophytosis (6), mucormycosis (3), two cases each of chromoblastomycosis, histoplasmosis, eumycetoma, entomophthoromycosis, sporotrichosis and Malassezia infection and a single case each of cryptococcosis and deep onychomycosis. Of the 53 (49.5%) cases with presumptive diagnosis data, only seven (13.2%) had a pre-biopsy suspicion of mycosis. There is a wide spectrum of mycoses in Ghana, including endemic mycoses not previously reported. Improving use of special fungal stains could increase yield and mycoses identification. Laboratory diagnostic capacity needs enhancement to complement histopathology investigations with serology, culture, and molecular methods.

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Section: Discussionmentioning

confidence: 99%

A diverse spectrum of mycoses histologically diagnosed in Ghana: Insights from a 10-year retrospective study

Ocansey,

Erskine,

Okine

et al. 2024

Medical Mycology

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“…In the future, molecular methods will play an increasingly important role in the diagnosis of HPM to assist clinicians. Their results are currently limited by the heterogeneity of molecular assays, the targets used, the small number of subjects included in the studies, the different types of specimens tested, and the lack of a standard comparative method, as well as the limited presence of molecular methods in international diagnostic guidelines [33].…”

Section: Molecular Methodsmentioning

confidence: 99%

Histoplasmosis: Laboratory Diagnosis

Dumea¹,

Danteş²

2023

Infectious Diseases

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The diagnosis of histoplasmosis is based on clinical, imaging, and laboratory evidence of the disease. The gold standards of laboratory diagnosis are the presence of the fungus in the pathological examination of tissues and its isolation (direct microscopy, histopathology, cytopathology) in mycological culture (4–6 weeks required) by clinical specimens. The antibody test, sometimes negative in immunocompromised patients, must be performed at least four weeks after acute infection to be positive. The antibody test is most useful in subacute and chronic forms of histoplasmosis. The antigen test is the most common method for establishing the diagnosis of acute pulmonary histoplasmosis or progressive disseminated histoplasmosis. The antigen test in urine or serum has good sensitivity, better in bronchoalveolar lavage fluid. There are skin sensitivity tests with low sensitivity that are used only for epidemiologic studies and are not recommended for diagnosis. Molecular diagnosis has improved the sensitivity of clinical specimens. Laboratory PCR assays with different molecular targets have been developed. Currently, the main procedure for molecular diagnosis of histoplasmosis is the application of a rapid DNA probe on a fungus isolated from a culture. This chapter summarizes the currently available tools for the laboratory diagnosis of histoplasmosis, focusing on the complexity of the assays and their performance in different clinical contexts.

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“…Broad-range or panfungal PCR assays use universal fungal primers to amplify part of the multi-copy rRNA gene cluster (usually the internal transcribed spacers 1 and 2 (ITS1 and ITS2) or the D1/D2 regions of the 28S rRNA gene) followed by DNA sequencing or high-resolution melt (HRM) curve analysis for identification of amplified targets [7,[20][21][22][23]. These assays are increasingly being utilised for definitive identification of fungal pathogens from a wide variety of clinical specimens including blood, fresh tissue and FFPE tissue.…”

Section: Broad-range Molecular Assaysmentioning

confidence: 99%

“…These assays are increasingly being utilised for definitive identification of fungal pathogens from a wide variety of clinical specimens including blood, fresh tissue and FFPE tissue. Other than increased sensitivity and specificity compared with conventional culture-based methods, they can detect novel and unexpected pathogens that may not present with an obvious clinical syndrome [8,22,24].…”

Section: Broad-range Molecular Assaysmentioning

confidence: 99%

“…The recent rise in incidence of endemic mycoses may be related to environmental changes, return of travel, increase in susceptible populations and improvements in diagnostics [22]. Histopathology requires expertise in interpretation, and culture-based methods require special precautions when handling culture isolates and demonstration of dimorphism for diagnosis.…”

Section: Endemic Mycosesmentioning

confidence: 99%

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Molecular Diagnostics for Invasive Fungal Diseases: Current and Future Approaches

Pham,

Sivalingam,

Tang

et al. 2024

JoF

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Invasive fungal diseases (IFDs) comprise a growing healthcare burden, especially given the expanding population of immunocompromised hosts. Early diagnosis of IFDs is required to optimise therapy with antifungals, especially in the setting of rising rates of antifungal resistance. Molecular techniques including nucleic acid amplification tests and whole genome sequencing have potential to offer utility in overcoming limitations with traditional phenotypic testing. However, standardisation of methodology and interpretations of these assays is an ongoing undertaking. The utility of targeted Aspergillus detection has been well-defined, with progress in investigations into the role of targeted assays for Candida, Pneumocystis, Cryptococcus, the Mucorales and endemic mycoses. Likewise, whilst broad-range polymerase chain reaction assays have been in use for some time, pathology stewardship and optimising diagnostic yield is a continuing exercise. As costs decrease, there is also now increased access and experience with whole genome sequencing, including metagenomic sequencing, which offers unparalleled resolution especially in the investigations of potential outbreaks. However, their role in routine diagnostic use remains uncommon and standardisation of techniques and workflow are required for wider implementation.

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Molecular Diagnosis of Endemic Mycoses

Cited by 4 publications

References 117 publications

A diverse spectrum of mycoses histologically diagnosed in Ghana: Insights from a 10-year retrospective study

A diverse spectrum of mycoses histologically diagnosed in Ghana: Insights from a 10-year retrospective study

Histoplasmosis: Laboratory Diagnosis

Molecular Diagnostics for Invasive Fungal Diseases: Current and Future Approaches

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