Khare Vibhu Ranjan, Gupta Munesh Kumar, Kumar Nilesh, Bhattnagar Ranjan, Tilak Ragini, Kumar Kailash, Kumar Chandan, Rana Anurag
Department of General Medicine, IMS, BHU, Varanasi, Uttar Pradesh, India.
Department of Microbiology, IMS, BHU, Varanasi, Uttar Pradesh, India.
J Family Med Prim Care. 2020 Sep 30;9(9):4992-4997. doi: 10.4103/jfmpc.jfmpc_775_20. eCollection 2020 Sep.
The aim and objective of this study is to detect invasive fungal infections (IFIs) early and with more sensitivity by the nested polymerase chain reaction (PCR) for fungus as compared to fungal culture in clinically suspected patients and also explore its correlation in reference to age, duration of symptoms, immunocompromised status, and other risk factors predisposing to IFIs.
In this cross-sectional study, 50 suspected patients admitted in medical acute care unit/intensive care unit (ACU/ICU) of Sir Sunderlal Hospital, Banaras Hindu University, Varanasi, India, comprised the study. All cases were selected based on the predefined inclusion and exclusion criteria. A detailed history, clinical examination, and all required investigations were done in all suspected patients. Blood samples were taken for nested-PCR for fungus and culture. Nested PCR was performed on extracted DNA form samples collected from all participants under the study.
Our study comprised of 50 suspected immunocompromised patients of IFIs. Among the participants under the study, the most common risk factor was diabetes mellitus (28% cases). Nearly two-thirds (60%) of the cases were 50 years or more. Around 70% of the cases had a history of illness more than 2 weeks. Nested PCR for fungus came out to be positive in 21/50 patients (42%); however, fungal culture was positive in none. Among the admitted patient in ACU/ICU, 75% were neutropenic.
IFIs are more common in immunocompromised individuals, patients with comorbidities, long history of symptoms, and elderly population. Nested PCR for fungus has a high sensitivity (as compared to the fungal culture), and also they are rapid in giving the results. Thus, nested PCR for fungus can be used in a cost-effective manner for the early and reliable diagnosis of clinically suspected IFIs.
本研究的目的是通过巢式聚合酶链反应（PCR）检测真菌，与真菌培养相比，在临床疑似患者中更早期且更灵敏地检测侵袭性真菌感染（IFI），并探讨其与年龄、症状持续时间、免疫功能低下状态以及其他易患IFI的危险因素之间的相关性。
在这项横断面研究中，纳入了印度瓦拉纳西贝拿勒斯印度教大学苏nder拉尔医院医疗急性护理单元/重症监护病房（ACU/ICU）收治的50例疑似患者。所有病例均根据预先确定的纳入和排除标准进行选择。对所有疑似患者进行了详细的病史、临床检查及所有必要的检查。采集血样进行真菌巢式PCR检测和培养。对研究中所有参与者采集的样本提取的DNA进行巢式PCR。
我们的研究包括50例疑似IFI的免疫功能低下患者。在研究参与者中，最常见的危险因素是糖尿病（28%的病例）。近三分之二（60%）的病例年龄在50岁及以上。约70%的病例病程超过2周。真菌巢式PCR在21/50例患者（42%）中呈阳性；然而，真菌培养均为阴性。在ACU/ICU收治的患者中，75%为中性粒细胞减少。
IFI在免疫功能低下个体、合并症患者、症状病史长的患者及老年人群中更为常见。真菌巢式PCR具有高灵敏度（与真菌培养相比），且结果出具迅速。因此，真菌巢式PCR可用于以经济有效的方式对临床疑似IFI进行早期和可靠的诊断。
