非曲霉菌霉菌感染的 PCR 诊断平台:是否已准备好在临床上常规使用?

IF 3.9 3区 医学 Q1 PATHOLOGY
Frederic Lamoth, Dimitrios P Kontoyiannis
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引用次数: 0

摘要

导言:虽然曲霉菌属仍然是侵袭性霉菌感染的主要病因,但非曲霉菌霉菌(如粘菌或镰刀菌属)在病例中所占的比例也在不断增加。非曲霉菌侵袭性霉菌感染(NAIMI)的诊断极具挑战性,因为传统微生物检验的灵敏度低且延迟。因此,人们特别关注开发分子工具,以便在血液或其他临床样本中对其进行早期检测:这篇广泛的文献综述讨论了黏菌类特异性 PCR 和其他属特异性或广谱真菌 PCR 的性能,这些 PCR 可用于诊断不同临床样本中的非传染性真菌感染,重点关注新型技术:目前,PCR 是最有前途的方法,它具有良好的灵敏度/特异性,能够在传统培养和组织病理学诊断之前检测临床样本中的 NAIMI。目前已设计出几种 PCR 检测方法,特别是用于检测粘孢子菌,也可用于检测镰刀菌属(Fusarium spp.)或孢子菌属(Scedosporium/Lomentospora spp.)。虽然仍需努力制定标准化方案并开发更快速、更简单的技术,但 PCR 正逐渐成为粘孢子菌病以及其他非传染性疾病早期诊断的一种基本检测方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
PCR diagnostic platforms for non-Aspergillus mold infections: ready for routine implementation in the clinic?

Introduction: While Aspergillus spp. remain the predominant cause of invasive mold infections, non-Aspergillus molds, such as the Mucorales or Fusarium spp., account for an increasing proportion of cases. The diagnosis of non-Aspergillus invasive mold infections (NAIMI) is challenging because of the low sensitivity and delay of conventional microbiological tests. Therefore, there is a particular interest to develop molecular tools for their early detection in blood or other clinical samples.

Areas covered: This extensive review of the literature discusses the performance of Mucorales-specific PCR and other genus-specific or broad-range fungal PCR that can be used for the diagnosis of NAIMI in diverse clinical samples, with a focus on novel technologies.

Expert opinion: PCR currently represents the most promising approach, combining good sensitivity/specificity and ability to detect NAIMI in clinical samples before diagnosis by conventional cultures and histopathology. Several PCR assays have been designed for the detection of Mucorales in particular, but also Fusarium spp. or Scedosporium/Lomentospora spp. Some commercial Mucorales PCRs are now available. While efforts are still needed for standardized protocols and the development of more rapid and simpler techniques, PCR is on the way to becoming an essential test for the early diagnosis of mucormycosis and possibly other NAIMIs.

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来源期刊
CiteScore
6.60
自引率
0.00%
发文量
71
审稿时长
1 months
期刊介绍: Expert Review of Molecular Diagnostics (ISSN 1473-7159) publishes expert reviews of the latest advancements in the field of molecular diagnostics including the detection and monitoring of the molecular causes of disease that are being translated into groundbreaking diagnostic and prognostic technologies to be used in the clinical diagnostic setting. Each issue of Expert Review of Molecular Diagnostics contains leading reviews on current and emerging topics relating to molecular diagnostics, subject to a rigorous peer review process; editorials discussing contentious issues in the field; diagnostic profiles featuring independent, expert evaluations of diagnostic tests; meeting reports of recent molecular diagnostics conferences and key paper evaluations featuring assessments of significant, recently published articles from specialists in molecular diagnostic therapy. Expert Review of Molecular Diagnostics provides the forum for reporting the critical advances being made in this ever-expanding field, as well as the major challenges ahead in their clinical implementation. The journal delivers this information in concise, at-a-glance article formats: invaluable to a time-constrained community.
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