Maubon Danièle, Garnaud Cécile, Ramarozatovo Lala Soavina, Fahafahantsoa Rapelanoro Rabenja, Cornet Muriel, Rasamoelina Tahinamandranto
Translational Innovation in Medicine and Complexity, Centre National de la Recherche Scientifique, Université Grenoble Alpes, Domaine de la Merci, Centre Hospitalier Universitaire Grenoble Alpes, Service de Parasitologie-Mycologie, Bd de la Chantourne, CEDEX, 38706 La Tronche, France.
Université Hospital Joseph Raseta Befelatanana, Antananarivo 101, Madagascar.
J Fungi (Basel). 2022 Apr 9;8(4):382. doi: 10.3390/jof8040382.
Chromoblastomycosis and sporotrichosis are the two main implantation mycoses that are now recognized as fungal neglected tropical diseases (NTDs). Their laboratory diagnosis mainly relies on direct microscopy, histopathology, and identification of the fungus by culture. However, to be appropriately used, these techniques require mycological expertise that is not widely available and may be absent in peripheral health care facilities in endemic areas. In addition, they lack sensitivity and specificity, and the culture for isolation and identification can have a long time-to-results period. Molecular methods, including matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), have been developed in well-equipped reference laboratories. They greatly improve the rapidity and accuracy of diagnosis; in particular, for species identification. Recently, PCR and sequencing have paved the way for more user-friendly point-of-care tests, such as those based on LAMP or RCA technologies, which can be used in basic healthcare settings and even in field consultations.
着色芽生菌病和孢子丝菌病是两种主要的植入性真菌病,现在被公认为是被忽视的热带真菌病(NTDs)。它们的实验室诊断主要依靠直接显微镜检查、组织病理学以及通过培养来鉴定真菌。然而,要恰当地使用这些技术,需要真菌学专业知识,而这种知识并不广泛可得,在流行地区的基层医疗保健机构中可能也不存在。此外,这些技术缺乏敏感性和特异性,用于分离和鉴定的培养可能需要很长时间才能得出结果。包括基质辅助激光解吸/电离飞行时间质谱(MALDI-TOF MS)在内的分子方法已在设备完善的参考实验室中得到开发。它们极大地提高了诊断的速度和准确性;特别是在菌种鉴定方面。最近,聚合酶链反应(PCR)和测序为更便于用户使用的即时检测铺平了道路,例如基于环介导等温扩增(LAMP)或滚环扩增(RCA)技术的检测,这些检测可用于基层医疗保健环境,甚至现场会诊。