Quantitative polymerase chain reaction detection of circulating DNA in serum for early diagnosis of mucormycosis in immunocompromised patients.
Laurence Millon
(1, 2)
,
Fabrice Larosa
(3)
,
Quentin Lepiller
(4)
,
Faezeh Legrand
(3)
,
Steffi Rocchi
(1)
,
Etienne Daguindau
(3)
,
Emeline Scherer
(1, 2)
,
Anne-Pauline Bellanger
(1, 2)
,
Joel Leroy
(5)
,
Frederic Grenouillet
(1, 2)
Laurence Millon
- Fonction : Auteur
- PersonId : 760476
- ORCID : 0000-0001-5939-3409
- IdRef : 058504656
Quentin Lepiller
- Fonction : Auteur
- PersonId : 772253
- ORCID : 0000-0003-2892-4216
Steffi Rocchi
- Fonction : Auteur
- PersonId : 1151387
- IdHAL : steffi-rocchi
- ORCID : 0000-0001-9262-1127
- IdRef : 187906866
Anne-Pauline Bellanger
- Fonction : Auteur
- PersonId : 760475
- ORCID : 0000-0003-4144-476X
Frederic Grenouillet
- Fonction : Auteur
- PersonId : 16667
- IdHAL : frederic-grenouillet
- ORCID : 0000-0001-6001-3135
- IdRef : 059337567
Résumé
BACKGROUND: The aim of our study was to assess the detection of circulating DNA from the most common species of Mucorales for early diagnosis of mucormycosis in at-risk patients. METHODS: We retrospectively evaluated a combination of 3 quantitative polymerase chain reaction (qPCR) assays using hydrolysis probes targeting Mucor/Rhizopus, Lichtheimia (formerly Absidia), and Rhizomucor for circulating Mucorales detection. Serial serum samples from 10 patients diagnosed with proven mucormycosis (2-9 samples per patient) were analyzed. RESULTS: No cross-reactivity was detected in the 3 qPCR assays using 19 reference strains of opportunistic fungi, and the limit of detection ranged from 3.7 to 15 femtograms/10 µL, depending on the species. DNA from Mucorales was detected in the serum of 9 of 10 patients between 68 and 3 days before mucormycosis diagnosis was confirmed by histopathological examination and/or positive culture. All the qPCR results were concordant with culture and/or PCR-based identification of the causing agents in tissue (Lichtheimia species, Rhizomucor species, and Mucor/Rhizopus species in 4, 3, and 2 patients, respectively). Quantitative PCR was negative in only 1 patient with proven disseminated mucormycosis caused by Lichtheimia species. CONCLUSION: Our study suggests that using specific qPCR targeting several species of Mucorales according to local ecology to screen at-risk patients could be useful in a clinical setting. The cost and efficacy of this strategy should be evaluated. However, given the human and economic cost of mucormycosis and the need for rapid diagnosis to initiate prompt directed antifungal therapy, this strategy could be highly attractive.
Domaines
MycologieFormat du dépôt | Notice |
---|---|
Type de dépôt | Article dans une revue |
Titre |
en
Quantitative polymerase chain reaction detection of circulating DNA in serum for early diagnosis of mucormycosis in immunocompromised patients.
|
Résumé |
en
BACKGROUND: The aim of our study was to assess the detection of circulating DNA from the most common species of Mucorales for early diagnosis of mucormycosis in at-risk patients. METHODS: We retrospectively evaluated a combination of 3 quantitative polymerase chain reaction (qPCR) assays using hydrolysis probes targeting Mucor/Rhizopus, Lichtheimia (formerly Absidia), and Rhizomucor for circulating Mucorales detection. Serial serum samples from 10 patients diagnosed with proven mucormycosis (2-9 samples per patient) were analyzed. RESULTS: No cross-reactivity was detected in the 3 qPCR assays using 19 reference strains of opportunistic fungi, and the limit of detection ranged from 3.7 to 15 femtograms/10 µL, depending on the species. DNA from Mucorales was detected in the serum of 9 of 10 patients between 68 and 3 days before mucormycosis diagnosis was confirmed by histopathological examination and/or positive culture. All the qPCR results were concordant with culture and/or PCR-based identification of the causing agents in tissue (Lichtheimia species, Rhizomucor species, and Mucor/Rhizopus species in 4, 3, and 2 patients, respectively). Quantitative PCR was negative in only 1 patient with proven disseminated mucormycosis caused by Lichtheimia species. CONCLUSION: Our study suggests that using specific qPCR targeting several species of Mucorales according to local ecology to screen at-risk patients could be useful in a clinical setting. The cost and efficacy of this strategy should be evaluated. However, given the human and economic cost of mucormycosis and the need for rapid diagnosis to initiate prompt directed antifungal therapy, this strategy could be highly attractive.
|
Auteur(s) |
Laurence Millon
1, 2
, Fabrice Larosa
3
, Quentin Lepiller
4
, Faezeh Legrand
3
, Steffi Rocchi
1
, Etienne Daguindau
3
, Emeline Scherer
1, 2
, Anne-Pauline Bellanger
1, 2
, Joel Leroy
5
, Frederic Grenouillet
1, 2
1
LCE -
Laboratoire Chrono-environnement (UMR 6249)
( 57629 )
- 16, route de Gray - 25030 Besançon Cedex
- France
2
Service de parasitologie et mycologie [CHRU de Besançon]
( 487743 )
- 3, boulevard A. Fleming - 25030 Besançon Cedex
- France
3
Service d'hématologie
( 111692 )
- France
4
API -
Agents pathogènes et inflammation - UFC (EA 4266)
( 109837 )
- Laboratoire de Virologie 2 place Saint-Jacques 25000 Besançon
- France
5
Service des maladies infectieuses et tropicales
( 109794 )
- 2 place Saint-Jacques 25000 Besançon
- France
|
Comité de lecture |
Oui
|
Vulgarisation |
Non
|
Langue du document |
Anglais
|
Nom de la revue |
|
Audience |
Internationale
|
Date de publication |
2013-05
|
Date de publication électronique |
2013-02-18
|
Volume |
56
|
Numéro |
10
|
Page/Identifiant |
e95-101
|
Domaine(s) |
|
Mots-clés (Mesh) |
|
DOI | 10.1093/cid/cit094 |
Pubmed Id | 23420816 |
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