Millon Laurence, Scherer Emeline, Rocchi Steffi, Bellanger Anne-Pauline
Parasitology Mycology Department, University Hospital, 25000 Besancon, France.
Chrono-Environnement UMR/CNRS 6249, University of Bourgogne Franche-Comté, 25000 Besançon, France.
J Fungi (Basel). 2019 Mar 20;5(1):24. doi: 10.3390/jof5010024.
Molecular techniques have provided a new understanding of the epidemiology of mucormycosis and improved the diagnosis and therapeutic management of this life-threatening disease. PCR amplification and sequencing were first applied to better identify isolates that were grown from cultures of biopsies or bronchalveolar lavage samples that were collected in patients with Mucorales infection. Subsequently, molecular techniques were used to identify the fungus directly from the infected tissues or from bronchalveolar lavage, and they helped to accurately identify Mucorales fungi in tissue samples when the cultures were negative. However, these tools require invasive sampling (biospsy, bronchalveolar lavage), which is not feasible in patients in poor condition in Hematology or Intensive Care units. Very recently, PCR-based procedures to detect Mucorales DNA in non-invasive samples, such as plasma or serum, have proved successful in diagnosing mucormycosis early in all patients, whatever the clinical status, and these procedures are becoming essential to improving patient outcome.
分子技术为毛霉病的流行病学提供了新的认识，并改善了对这种危及生命疾病的诊断和治疗管理。聚合酶链反应（PCR）扩增和测序最初被用于更好地鉴定从毛霉目感染患者活检组织或支气管肺泡灌洗样本培养物中生长的分离株。随后，分子技术被用于直接从感染组织或支气管肺泡灌洗物中鉴定真菌，当培养结果为阴性时，它们有助于准确鉴定组织样本中的毛霉目真菌。然而，这些工具需要进行侵入性采样（活检、支气管肺泡灌洗），这对于血液科或重症监护病房中病情不佳的患者来说是不可行的。最近，基于PCR的方法用于检测非侵入性样本（如血浆或血清）中的毛霉目DNA，已被证明在早期诊断所有患者的毛霉病方面取得了成功，无论其临床状况如何，并且这些方法对于改善患者预后正变得至关重要。
