Springer J, McCormick Smith I, Hartmann S, Winkelmann R, Wilmes D, Cornely O, Kessel J, Löffler J, Rickerts V
University of Würzburg, Dept. for internal Medicine II, Würzburg, Germany.
Robert Koch Institut, Berlin, Germany.
Med Mycol. 2019 Apr 1;57(3):308-313. doi: 10.1093/mmy/myy041.
Establishing the etiology of invasive fungal infections is important to guide therapeutic options and for epidemiologic purposes. Formalin-fixed, paraffin-embedded (FFPE) tissue specimens from patients with proven invasive fungal infections are valuable to determine the etiology of systemic fungal infections. We compared different polymerase chain reaction (PCR) amplification strategies from FFPE tissue blocks to identify agents of invasive fungal infections. We found that specific PCR assays show superior sensitivity in the identification of DNA of Mucorales and Aspergillus and mixed infections caused by both as compared to broad-range PCR assays. Shorter amplicon lengths and less detection of contaminating fungal DNA are potential factors involved. However, detection of fungal DNA by highly sensitive specific PCR assays in the absence of demonstration of fungal elements in tissue suggests that PCR results should be interpreted in the context of the histopathology and clinical findings.
确定侵袭性真菌感染的病因对于指导治疗方案的选择以及流行病学研究具有重要意义。来自确诊侵袭性真菌感染患者的福尔马林固定、石蜡包埋（FFPE）组织标本对于确定系统性真菌感染的病因很有价值。我们比较了从FFPE组织块中进行不同聚合酶链反应（PCR）扩增策略，以识别侵袭性真菌感染的病原体。我们发现，与广谱PCR检测相比，特异性PCR检测在鉴定毛霉目和曲霉属的DNA以及由两者引起的混合感染方面显示出更高的灵敏度。较短的扩增子长度和较少的污染真菌DNA检测是其中涉及的潜在因素。然而，在组织中未发现真菌成分的情况下，通过高灵敏度特异性PCR检测来检测真菌DNA表明，PCR结果应结合组织病理学和临床发现进行解读。
