PCR with electrospray ionization-mass spectrometry on bronchoalveolar lavage for detection of invasive mold infections in hematological patients

Autor: Måns Ullberg, Ola Blennow, Kristoffer Strålin, Anders Krifors, Malin Ackefors, Volkan Özenci, Martin Jädersten
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
Artificial Gene Amplification and Extension
Aspergillosis
Pathology and Laboratory Medicine
Gastroenterology
Polymerase Chain Reaction
Aspergillus fumigatus
law.invention
law
Medicine and Health Sciences
Polymerase chain reaction
Fungal Pathogens
Multidisciplinary
Hematology
biology
medicine.diagnostic_test
Antimicrobials
Fungal Diseases
Eukaryota
Drugs
Middle Aged
Aspergillus
Infectious Diseases
Aspergillus Fumigatus
Fungal Molds
Medical Microbiology
Hematologic Neoplasms
Mucorales
Medicine
Female
Pathogens
Bronchoalveolar Lavage Fluid
Research Article
Adult
medicine.medical_specialty
Spectrometry
Mass
Electrospray Ionization
Electrospray ionization
Science
Mycology
Research and Analysis Methods
Microbiology
Diagnostic Medicine
Internal medicine
Microbial Control
medicine
Humans
Mucormycosis
Molecular Biology Techniques
Molecular Biology
Microbial Pathogens
Aged
Retrospective Studies
Pharmacology
Antifungals
business.industry
Organisms
Fungi
technology
industry
and agriculture
Biology and Life Sciences
biology.organism_classification
medicine.disease
Bronchoalveolar lavage
Pulmonary Aspergillosis
business
Zdroj: PLoS ONE, Vol 14, Iss 2, p e0212812 (2019)
PLoS ONE
ISSN: 1932-6203
Popis: Invasive mold infections are life-threatening complications in patients with hematological malignancies. Conventional microbiological methods for diagnosing invasive pulmonary mold infections have low sensitivity, and molecular methods are being developed. Detection of molds using PCR with a narrow spectrum has been reported, but data with broad-spectrum PCR are lacking. In this study, the diagnostic performance and utility of a broad-spectrum PCR (broad-spectrum PCR with subsequent electrospray ionization-mass spectrometry, PCR/ESI-MS) for detection of molds in bronchoalveolar lavage (BAL) in 27 hematological patients with a new pulmonary infiltrate was analyzed. Using the revised EORTC/MSG criteria, PCR/ESI-MS was the only positive microbiological test in patients with proven invasive mold infection (n = 2) and correctly identified all cases of probable invasive pulmonary aspergillosis (n = 5). In patients with a possible invasive mold infection (n = 5), PCR/ESI-MS was positive in three patients. Mucorales was identified with PCR/ESI-MS in four patients that were all culture negative. The PCR/ESI-MS results had a clinical impact on antifungal therapy in 12 (44%) of the patients: modification of treatment in 6 (22%) patients and discontinuation in 6 (22%) patients. This study provides proof of concept that routine use of a broad-spectrum PCR for molds in bronchoalveolar lavage in immunocompromised patients is sensitive, fast, and has an impact on clinical decision-making.
Databáze: OpenAIRE
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