Clinical Microbiology Service, Department of Laboratory Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, New York 10065, USA.
J Clin Microbiol. 2011 Nov;49(11):3777-82. doi: 10.1128/JCM.01135-11. Epub 2011 Aug 31.
Invasive fungal infections (IFI) remain a serious threat to immunocompromised hosts. Current diagnostic methods, including fungal culture and antigen detection, are slow and often lack specificity. Rapid diagnostic tools with increased sensitivity and specificity could improve the care of patients with IFI. Recently, Luminex Molecular Diagnostics (Toronto, Canada) developed 23 analyte-specific reagents (ASRs) for the detection of the most common clinically relevant fungi. This study's objective was to evaluate the sensitivity and specificity of a subset of these ASRs for fungal isolates and clinical specimens. Previously characterized fungal and bacterial isolates (n = 110), blood culture specimens (n = 34), and respiratory specimens (n = 44) were tested using either a Candida 7-plex panel (Candida albicans, Candida glabrata, Candida tropicalis, Candida parapsilosis, Candida lusitaniae, Candida guilliermondii, and Candida krusei) or a mold 11-plex panel (Aspergillus fumigatus, Aspergillus flavus, Aspergillus niger, Aspergillus terreus, Scedosporium prolificans, Scedosporium apiospermum, Fusarium oxysporum/Fusarium solani, Rhizopus arrhizus, Rhizopus microsporus, Mucor indicus, and Cunninghamella bertholletiae). The Candida 7-plex panel correctly identified all Candida isolates as confirmed by fungal culture and biochemical tests, for a sensitivity and specificity of 100%. The mold 11-plex panel correctly identified all mold isolates tested except for A. niger. Fungal isolates of Rhizopus and Mucor species were not detected, either, although they could represent species other than those targeted by the ASRs. Further evaluation will be necessary to confirm the sensitivities of some of the mold ASRs. Implementation of these ASRs will allow same-day detection of fungal DNA in clinical specimens.
侵袭性真菌感染（IFI）仍然是免疫功能低下宿主的严重威胁。目前的诊断方法，包括真菌培养和抗原检测，速度较慢，且通常缺乏特异性。具有更高灵敏度和特异性的快速诊断工具可以改善IFI 患者的治疗效果。最近，加拿大多伦多的 Luminex Molecular Diagnostics 公司开发了 23 种针对最常见临床相关真菌的分析物特异性试剂（ASR）。本研究的目的是评估这些 ASR 中的一部分对真菌分离株和临床标本的灵敏度和特异性。使用 Candida 7 重组合 panel（Candida albicans、Candida glabrata、Candida tropicalis、Candida parapsilosis、Candida lusitaniae、Candida guilliermondii 和 Candida krusei）或 mold 11 重组合 panel（Aspergillus fumigatus、Aspergillus flavus、Aspergillus niger、Aspergillus terreus、Scedosporium prolificans、Scedosporium apiospermum、Fusarium oxysporum/Fusarium solani、Rhizopus arrhizus、Rhizopus microsporus、Mucor indicus 和 Cunninghamella bertholletiae）对之前经过特征描述的真菌和细菌分离株（n=110）、血培养标本（n=34）和呼吸道标本（n=44）进行了检测。Candida 7 重组合 panel 通过真菌培养和生化试验确认，正确鉴定了所有的 Candida 分离株，灵敏度和特异性均为 100%。mold 11 重组合 panel 正确鉴定了除 Aspergillus niger 以外的所有测试的 mold 分离株。此外，虽然它们可能代表 ASRs 针对的目标之外的其他物种，但也未检测到 Rhizopus 和 Mucor 种的真菌分离株。需要进一步评估来确认一些 mold ASRs 的灵敏度。实施这些 ASRs 将允许在临床标本中当天检测到真菌 DNA。
