Barnes Rosemary A, White P Lewis
Department of Medical Microbiology and Infectious Diseases, Cardiff University School of Medicine, Cardiff CF14 4XN, UK.
Public Health Wales Microbiology, Cardiff CF14 4 XW, UK.
J Fungi (Basel). 2016 Aug 11;2(3):23. doi: 10.3390/jof2030023.
The application of molecular technologies to aid diagnosis and management of infectious diseases has had a major impact and many assays are in routine use. Diagnosis of aspergillosis has lagged behind. Lack of standardization and limited commercial interest have meant that PCR was not included in consensus diagnostic criteria for invasive fungal disease. In the last ten years careful evaluation and validation by the Aspergillus European PCR initiative with the development of standardized extraction, amplification and detection protocols for various specimen types, has provided the opportunity for clinical utility to be investigated. PCR has the potential to not only exclude a diagnosis of invasive aspergillosis but in combination with antigen testing may offer an approach for the early diagnosis and treatment of invasive aspergillosis in high-risk populations, with the added benefit of detection of genetic markers associated with antifungal resistance.
分子技术在辅助传染病诊断和管理中的应用产生了重大影响,许多检测方法已在常规使用。曲霉病的诊断则滞后了。缺乏标准化以及商业利益有限意味着PCR未被纳入侵袭性真菌病的共识诊断标准。在过去十年中,欧洲曲霉PCR倡议进行了仔细评估和验证,开发了针对各种标本类型的标准化提取、扩增和检测方案,为研究其临床实用性提供了机会。PCR不仅有可能排除侵袭性曲霉病的诊断,而且与抗原检测相结合,可能为高危人群侵袭性曲霉病的早期诊断和治疗提供一种方法,还有检测与抗真菌耐药性相关的遗传标记这一额外益处。