Vaezi Afsane, Fakhim Hamed, Ilkit Macit, Faeli Leila, Fakhar Mahdi, Alinejad Vahid, Wiederhold Nathan P, Badali Hamid
Invasive Fungi Research Center, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Front Microbiol. 2020 Mar 20;11:440. doi: 10.3389/fmicb.2020.00440. eCollection 2020.
Prompt and targeted antifungal treatment has a positive impact on the clinical outcome of mucormycosis; however, current diagnostic tools used in histopathology laboratories often fail to provide rapid results. Rapid culture-based strategies for early diagnosis of infections, which may influence treatment decisions, are urgently needed. Herein, we evaluated a microculture assay for the early diagnosis of mucormycosis in an immunocompetent murine model of disseminated infection, by comparing it with traditional diagnostic methods. The assay specificity was assessed using blood ( = 90) and tissue ( = 90) specimens obtained from mice infected with using different inoculum sizes [1 × 10, 1 × 10, and 1 × 10 colony forming units (CFUs)/mouse] and blood ( = 15) and tissue specimens ( = 15) from uninfected mice. Surprisingly, 26 of 90 (28.9%) blood samples revealed positive results by microculture, whereas all blood samples were negative when assayed by conventional culture. The overall positive conventional culture rate for the mouse tissue (kidney) samples was 31.1% (28/90). The calculated sensitivity for kidney microculture was 98.8% [95% confidence interval (CI) 96.6-100], with an assay specificity of 100%. Hence, the microculture assay may be useful for rapid culturing and diagnosis of mucormycosis caused by directly in blood and tissue samples. Hence, this method may allow for the timely administration of an appropriate treatment.
及时且有针对性的抗真菌治疗对毛霉菌病的临床结果有积极影响；然而，组织病理学实验室目前使用的诊断工具往往无法提供快速结果。迫切需要基于培养的快速策略来早期诊断感染，这可能会影响治疗决策。在此，我们通过将一种微量培养测定法与传统诊断方法进行比较，评估了其在免疫功能正常的播散性感染小鼠模型中对毛霉菌病的早期诊断能力。使用从感染不同接种量[1×10、1×10和1×10菌落形成单位（CFU）/小鼠]的小鼠获得的血液（n = 90）和组织（n = 90）标本以及未感染小鼠的血液（n = 15）和组织标本（n = 15）评估该测定法的特异性。令人惊讶的是，90份血液样本中有26份（28.9%）通过微量培养显示阳性结果，而通过传统培养检测时所有血液样本均为阴性。小鼠组织（肾脏）样本的传统培养总体阳性率为31.1%（28/90）。计算得出肾脏微量培养的敏感性为98.8%[95%置信区间（CI）96.6 - 100]，测定特异性为100%。因此，微量培养测定法可能有助于直接在血液和组织样本中快速培养和诊断由引起的毛霉菌病。因此，这种方法可能允许及时给予适当的治疗。
