ABSTRACT
Rapid, accurate diagnostic laboratory tests are needed to improve clinical outcomes of invasive fungal disease (IFD). Traditional direct microscopy, culture and histological techniques constitute the 'gold standard' against which newer tests are judged. Molecular diagnostic methods, whether broad-range or fungal-specific, have great potential to enhance sensitivity and speed of IFD diagnosis, but have varying specificities. The use of PCR-based assays, DNA sequencing, and other molecular methods including those incorporating proteomic approaches such as matrix-assisted laser desorption ionisation-time of flight mass spectroscopy (MALDI-TOF MS) have shown promising results. These are used mainly to complement conventional methods since they require standardisation before widespread implementation can be recommended. None are incorporated into diagnostic criteria for defining IFD. Commercial assays may assist standardisation. This review provides an update of molecular-based diagnostic approaches applicable to biological specimens and fungal cultures in microbiology laboratories. We focus on the most common pathogens, Candida and Aspergillus, and the mucormycetes. The position of molecular-based approaches in the detection of azole and echinocandin antifungal resistance is also discussed.
Subject(s)
Molecular Diagnostic Techniques , Mycological Typing Techniques/trends , Mycoses/diagnosis , HumansABSTRACT
Sepsis is a rapidly progressing, severe inflammatory response to infection, causing more than 200,000 deaths per year. Rapid, specific pathogen identification is important to guide sepsis treatment. In this review, we describe and compare currently available commercial products for sepsis diagnosis and pathogen identification, based on microbiological, molecular, and mass spectrometric technologies. Microbiological techniques, the current "gold standard" in sepsis pathogen identification, include blood culture followed by subculturing and pathogen identification via biochemical or microscopic means. These methods have been automated but nevertheless require several days to generate results. Alternative technologies, including highly multiplexed PCR-based methods and mass spectrometric approaches, can decrease the required turnaround time. Matrix-assisted laser-desorption ionization time-of-flight-based systems have recently become an attractive option to rapidly identify a broad spectrum of sepsis pathogens with good sensitivity and specificity. Effectively integrating rapid sepsis pathogen identification into the hospital workflow can improve patient outcomes and can reduce the length of hospitalization and cost per patient.
Subject(s)
Bacterial Infections/diagnosis , Fungi/isolation & purification , Gram-Negative Bacteria/isolation & purification , Gram-Positive Bacteria/isolation & purification , Mycoses/diagnosis , Sepsis/diagnosis , Shock, Septic/diagnosis , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Antifungal Agents/pharmacology , Antifungal Agents/therapeutic use , Automation, Laboratory , Bacterial Infections/drug therapy , Bacterial Infections/microbiology , Diagnosis, Differential , Fungi/classification , Fungi/drug effects , Fungi/growth & development , Gram-Negative Bacteria/classification , Gram-Negative Bacteria/drug effects , Gram-Negative Bacteria/growth & development , Gram-Positive Bacteria/classification , Gram-Positive Bacteria/drug effects , Gram-Positive Bacteria/growth & development , Humans , Microbial Sensitivity Tests , Molecular Typing/trends , Mycological Typing Techniques/trends , Mycoses/drug therapy , Mycoses/microbiology , Sepsis/drug therapy , Sepsis/microbiology , Shock, Septic/drug therapy , Shock, Septic/microbiology , Viruses/classification , Viruses/drug effects , Viruses/isolation & purificationSubject(s)
Infectious Disease Medicine/methods , Mycology/methods , Mycoses , Proteomics , Animals , Diagnostic Techniques and Procedures/trends , Electrophoresis, Gel, Two-Dimensional , Humans , Infectious Disease Medicine/trends , Mycological Typing Techniques/trends , Mycology/trends , Mycoses/diagnosis , Mycoses/therapy , Proteomics/trends , Rats , Spectrometry, Mass, Matrix-Assisted Laser Desorption-IonizationABSTRACT
The clinical presentation of fungal infections of the skin, hair, and nails is varied and sometimes presents a confusing clinical picture. The main objective is to rapidly institute diagnostic measures to avoid delays in therapy with potential expansion of the infection. A variety of laboratory tests are required. Classical methods are based on microscopy, different culture procedures, and histologic examination. Genotypic approaches to detection and identification of fungal pathogens have become very rapid and sensitive, making them additional options for routine diagnosis.
Subject(s)
Arthrodermataceae/isolation & purification , Dermatomycoses/diagnosis , Dermatomycoses/microbiology , Molecular Probe Techniques/trends , Mycological Typing Techniques/methods , Mycological Typing Techniques/trends , HumansABSTRACT
The focus of this review is the evolution of biochemical phenotypic yeast identification methods with emphasis on conventional approaches, rapid screening tests, chromogenic agars, comprehensive commercial methods, and the eventual migration to genotypic methods. As systemic yeast infections can be devastating and resistance is common in certain species, accurate identification to the species level is paramount for successful therapy and appropriate patient care.
Subject(s)
Mycological Typing Techniques , Mycology/methods , Yeasts/classification , Yeasts/isolation & purification , Genotype , Humans , Mycological Typing Techniques/trends , Mycoses/diagnosis , Mycoses/microbiology , PhenotypeABSTRACT
Mycotoxins are fungal metabolites that pose a health risk to exposed animals and humans. In recent years, concern has mounted regarding human exposure to mycotoxins via inhalation of mold spores produced in damp buildings and homes. Although mycotoxins can be detected in such buildings, reliable means for measuring an occupant's level of exposure to most mycotoxins are lacking. The author briefly reviews the chemical methods currently available for mycotoxin analysis, outlining accepted practices and discussing the limitations of these measurements.
Subject(s)
Air Pollution, Indoor/analysis , Environmental Monitoring/methods , Inhalation Exposure/analysis , Mycological Typing Techniques/methods , Mycotoxins/analysis , Mycotoxins/chemistry , Air Pollution, Indoor/adverse effects , Antibodies, Fungal/analysis , Antibodies, Fungal/blood , Antibodies, Fungal/immunology , Environmental Illness/diagnosis , Environmental Illness/etiology , Environmental Illness/immunology , Forecasting , Humans , Immunoassay/methods , Immunoassay/trends , Inhalation Exposure/adverse effects , Mycological Typing Techniques/trends , Mycotoxins/immunology , Mycotoxins/isolation & purification , Mycotoxins/metabolism , Mycotoxins/poisoning , Sick Building Syndrome/diagnosis , Sick Building Syndrome/etiology , Sick Building Syndrome/immunologyABSTRACT
Siendo las Micobacterias capaces de sobrevivir en aguas corrientes y residuales; y a fin de valorar el riesgo de contaminacion humana, se realizo una investigacion dirigida a objetivos especificos, como ser: 1. Investigacion de Micobacterias en aguas de uso potable de domicilios y centros hospitalarios -En aguas, piscinas y saunas de uso publico -En aguas residuales y rios 2.Tipificacion y estudio de sensibilidad y resistencia a quimioterapicos 3. Demostrar el valor epidemiologico de las aguas contaminadas
