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Serial Detection of Circulating Mucorales DNA in Invasive Mucormycosis: A Retrospective Multicenter Evaluation

Invasive mucormycosis is a fungal infection with high mortality. Early diagnosis and initiation of appropriate treatment is essential to improve survival. However, current diagnostic tools suffer from low sensitivity, leading to delayed or missed diagnoses. Recently, several PCR assays for the detec...

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Autores principales: Mercier, Toine, Reynders, Marijke, Beuselinck, Kurt, Guldentops, Ellen, Maertens, Johan, Lagrou, Katrien
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6958450/
https://www.ncbi.nlm.nih.gov/pubmed/31816976
http://dx.doi.org/10.3390/jof5040113
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author Mercier, Toine
Reynders, Marijke
Beuselinck, Kurt
Guldentops, Ellen
Maertens, Johan
Lagrou, Katrien
author_facet Mercier, Toine
Reynders, Marijke
Beuselinck, Kurt
Guldentops, Ellen
Maertens, Johan
Lagrou, Katrien
author_sort Mercier, Toine
collection PubMed
description Invasive mucormycosis is a fungal infection with high mortality. Early diagnosis and initiation of appropriate treatment is essential to improve survival. However, current diagnostic tools suffer from low sensitivity, leading to delayed or missed diagnoses. Recently, several PCR assays for the detection of Mucorales DNA have been developed. We retrospectively assessed the diagnostic and kinetic properties of a commercial Mucorales PCR assay (MucorGenius(®), PathoNostics) on serial blood samples from patients with culture-positive invasive mucormycosis and found an overall sensitivity of 75%. Importantly, a positive test preceded a positive culture result by up to 81 days (median eight days, inter-quartile range 1.75–16.25). After initiation of appropriate therapy, the average levels of circulating DNA decreased after one week and stabilized after two weeks. In conclusion, detection of circulating Mucorales DNA appears to be a good, fast diagnostic test that often precedes the final diagnosis by several days to weeks. This test could be especially useful in cases in which sampling for culture or histopathology is not feasible.
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spelling pubmed-69584502020-01-23 Serial Detection of Circulating Mucorales DNA in Invasive Mucormycosis: A Retrospective Multicenter Evaluation Mercier, Toine Reynders, Marijke Beuselinck, Kurt Guldentops, Ellen Maertens, Johan Lagrou, Katrien J Fungi (Basel) Article Invasive mucormycosis is a fungal infection with high mortality. Early diagnosis and initiation of appropriate treatment is essential to improve survival. However, current diagnostic tools suffer from low sensitivity, leading to delayed or missed diagnoses. Recently, several PCR assays for the detection of Mucorales DNA have been developed. We retrospectively assessed the diagnostic and kinetic properties of a commercial Mucorales PCR assay (MucorGenius(®), PathoNostics) on serial blood samples from patients with culture-positive invasive mucormycosis and found an overall sensitivity of 75%. Importantly, a positive test preceded a positive culture result by up to 81 days (median eight days, inter-quartile range 1.75–16.25). After initiation of appropriate therapy, the average levels of circulating DNA decreased after one week and stabilized after two weeks. In conclusion, detection of circulating Mucorales DNA appears to be a good, fast diagnostic test that often precedes the final diagnosis by several days to weeks. This test could be especially useful in cases in which sampling for culture or histopathology is not feasible. MDPI 2019-12-03 /pmc/articles/PMC6958450/ /pubmed/31816976 http://dx.doi.org/10.3390/jof5040113 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Mercier, Toine
Reynders, Marijke
Beuselinck, Kurt
Guldentops, Ellen
Maertens, Johan
Lagrou, Katrien
Serial Detection of Circulating Mucorales DNA in Invasive Mucormycosis: A Retrospective Multicenter Evaluation
title Serial Detection of Circulating Mucorales DNA in Invasive Mucormycosis: A Retrospective Multicenter Evaluation
title_full Serial Detection of Circulating Mucorales DNA in Invasive Mucormycosis: A Retrospective Multicenter Evaluation
title_fullStr Serial Detection of Circulating Mucorales DNA in Invasive Mucormycosis: A Retrospective Multicenter Evaluation
title_full_unstemmed Serial Detection of Circulating Mucorales DNA in Invasive Mucormycosis: A Retrospective Multicenter Evaluation
title_short Serial Detection of Circulating Mucorales DNA in Invasive Mucormycosis: A Retrospective Multicenter Evaluation
title_sort serial detection of circulating mucorales dna in invasive mucormycosis: a retrospective multicenter evaluation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6958450/
https://www.ncbi.nlm.nih.gov/pubmed/31816976
http://dx.doi.org/10.3390/jof5040113
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