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Diagnostic Performance and Clinical Utility of Conventional PCR Assay in Early Diagnosis of COVID-19 Associated Rhino-Orbito-Cerebral Mucormycosis

Early diagnosis and treatment of rhino-orbital-cerebral mucormycosis (ROCM) are crucial. Potassium hydroxide with Calcofluorwhite (KOH + CFW) smears can demonstrate the fungal hyphae, but mixed infections caused by both mucorales and non-mucorales pose a diagnostic challenge. Polymerase chain reacti...

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Autores principales: Mohapatra, Samir, Barik, Manas Ranjan, Rath, Suryasnata, Sharma, Savitri, Mohapatra, Archisman, Behera, Sharmistha, Acharya, Souvagini, Pattjoshi, Dipti Ranjan, Padhi, Rajesh Kumar, Behera, Himansu Sekhar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9409716/
https://www.ncbi.nlm.nih.gov/pubmed/36012832
http://dx.doi.org/10.3390/jof8080844
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author Mohapatra, Samir
Barik, Manas Ranjan
Rath, Suryasnata
Sharma, Savitri
Mohapatra, Archisman
Behera, Sharmistha
Acharya, Souvagini
Pattjoshi, Dipti Ranjan
Padhi, Rajesh Kumar
Behera, Himansu Sekhar
author_facet Mohapatra, Samir
Barik, Manas Ranjan
Rath, Suryasnata
Sharma, Savitri
Mohapatra, Archisman
Behera, Sharmistha
Acharya, Souvagini
Pattjoshi, Dipti Ranjan
Padhi, Rajesh Kumar
Behera, Himansu Sekhar
author_sort Mohapatra, Samir
collection PubMed
description Early diagnosis and treatment of rhino-orbital-cerebral mucormycosis (ROCM) are crucial. Potassium hydroxide with Calcofluorwhite (KOH + CFW) smears can demonstrate the fungal hyphae, but mixed infections caused by both mucorales and non-mucorales pose a diagnostic challenge. Polymerase chain reaction (PCR) can detect mixed infections and differentiate mucorales from non-mucorales. This study aimed to evaluate the utility of a single reaction PCR in the diagnosis of ROCM and the efficacy of nasal biopsy and endonasal swab in the detection of fungus. Sixty-six clinical samples were collected from 33 patients and were subjected to KOH + CFW smear, culture and PCR. PCR was performed using pan-fungal primers targeting the 28S large subunit rRNA gene, and the amplified products were further sequenced to identify the fungi. KOH + CFW smear, culture and PCR detected mucorales in 54.6%, 27.3% and 63.6% patients, respectively. PCR detected mixed infection in 51.5% patients compared to 9.1% by KOH + CFW smear. PCR detected fungus in 90% of nasal biopsies and 77.8% of endonasal swabs. Rhizopus spp. was the most common fungi identified in 43.2% of PCR-positive samples. PCR is effective in detecting mixed infection and in the diagnosis of ROCM. Nasal biopsies had better fungal detection rates than endonasal swabs.
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spelling pubmed-94097162022-08-26 Diagnostic Performance and Clinical Utility of Conventional PCR Assay in Early Diagnosis of COVID-19 Associated Rhino-Orbito-Cerebral Mucormycosis Mohapatra, Samir Barik, Manas Ranjan Rath, Suryasnata Sharma, Savitri Mohapatra, Archisman Behera, Sharmistha Acharya, Souvagini Pattjoshi, Dipti Ranjan Padhi, Rajesh Kumar Behera, Himansu Sekhar J Fungi (Basel) Article Early diagnosis and treatment of rhino-orbital-cerebral mucormycosis (ROCM) are crucial. Potassium hydroxide with Calcofluorwhite (KOH + CFW) smears can demonstrate the fungal hyphae, but mixed infections caused by both mucorales and non-mucorales pose a diagnostic challenge. Polymerase chain reaction (PCR) can detect mixed infections and differentiate mucorales from non-mucorales. This study aimed to evaluate the utility of a single reaction PCR in the diagnosis of ROCM and the efficacy of nasal biopsy and endonasal swab in the detection of fungus. Sixty-six clinical samples were collected from 33 patients and were subjected to KOH + CFW smear, culture and PCR. PCR was performed using pan-fungal primers targeting the 28S large subunit rRNA gene, and the amplified products were further sequenced to identify the fungi. KOH + CFW smear, culture and PCR detected mucorales in 54.6%, 27.3% and 63.6% patients, respectively. PCR detected mixed infection in 51.5% patients compared to 9.1% by KOH + CFW smear. PCR detected fungus in 90% of nasal biopsies and 77.8% of endonasal swabs. Rhizopus spp. was the most common fungi identified in 43.2% of PCR-positive samples. PCR is effective in detecting mixed infection and in the diagnosis of ROCM. Nasal biopsies had better fungal detection rates than endonasal swabs. MDPI 2022-08-11 /pmc/articles/PMC9409716/ /pubmed/36012832 http://dx.doi.org/10.3390/jof8080844 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Mohapatra, Samir
Barik, Manas Ranjan
Rath, Suryasnata
Sharma, Savitri
Mohapatra, Archisman
Behera, Sharmistha
Acharya, Souvagini
Pattjoshi, Dipti Ranjan
Padhi, Rajesh Kumar
Behera, Himansu Sekhar
Diagnostic Performance and Clinical Utility of Conventional PCR Assay in Early Diagnosis of COVID-19 Associated Rhino-Orbito-Cerebral Mucormycosis
title Diagnostic Performance and Clinical Utility of Conventional PCR Assay in Early Diagnosis of COVID-19 Associated Rhino-Orbito-Cerebral Mucormycosis
title_full Diagnostic Performance and Clinical Utility of Conventional PCR Assay in Early Diagnosis of COVID-19 Associated Rhino-Orbito-Cerebral Mucormycosis
title_fullStr Diagnostic Performance and Clinical Utility of Conventional PCR Assay in Early Diagnosis of COVID-19 Associated Rhino-Orbito-Cerebral Mucormycosis
title_full_unstemmed Diagnostic Performance and Clinical Utility of Conventional PCR Assay in Early Diagnosis of COVID-19 Associated Rhino-Orbito-Cerebral Mucormycosis
title_short Diagnostic Performance and Clinical Utility of Conventional PCR Assay in Early Diagnosis of COVID-19 Associated Rhino-Orbito-Cerebral Mucormycosis
title_sort diagnostic performance and clinical utility of conventional pcr assay in early diagnosis of covid-19 associated rhino-orbito-cerebral mucormycosis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9409716/
https://www.ncbi.nlm.nih.gov/pubmed/36012832
http://dx.doi.org/10.3390/jof8080844
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