Back to Search
Start Over
Challenges in microbiological diagnosis of invasive Aspergillus infections [version 1; referees: 2 approved]
- Source :
- F1000Research. 6:F1000 Faculty Rev-157
- Publication Year :
- 2017
- Publisher :
- London, UK: F1000 Research Limited, 2017.
-
Abstract
- Invasive aspergillosis (IA) has been increasingly reported in populations other than the historical hematology patients and there are new questions about the performance of microbiological tools. Microscopy and culture have been completed by biomarkers, either antigens or DNA, and in blood or respiratory specimens or both. First studied in hematology, the antigen galactomannan performance in serum is low in other patient populations where the pathophysiology of the infection can be different and the prevalence of IA is much lower. DNA detection with polymerase chain reaction (PCR) in blood or serum (or both) has reached a certain level of acceptance thanks to consensus methods based on real-time quantitative PCR (qPCR). When used on respiratory specimens, galactomannan and qPCR depend on standardization of the sampling and the diverse mycological procedures. Thus, culture remains the main diagnostic criterion in critically ill patients. The current trend toward more effective anti-mold prophylaxis in hematology hampers the yield of a screening strategy, as is usually performed in hematology. Therefore, circulating biomarkers as confirmatory tests should be considered and their performance should be reappraised in each new setting. The use of azole prophylaxis also raises the issue of selecting azole-resistance Aspergillus fumigatus isolates. Ideally, the biomarkers will be more efficient when individual genetic risks of IA are defined. Culture, though not standardized, remains a key element for the diagnosis of IA and has the advantage to easily detect molds other than A. fumigatus. It is still unclear whether next-generation sequencing will replace culture in the future.
Details
- ISSN :
- 20461402
- Volume :
- 6
- Database :
- F1000Research
- Journal :
- F1000Research
- Notes :
- Editorial Note on the Review Process F1000 Faculty Reviews are commissioned from members of the prestigious F1000 Faculty and are edited as a service to readers. In order to make these reviews as comprehensive and accessible as possible, the referees provide input before publication and only the final, revised version is published. The referees who approved the final version are listed with their names and affiliations but without their reports on earlier versions (any comments will already have been addressed in the published version). The referees who approved this article are: Jacques Meis, Centre of Expertise in Mycology, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands; Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, Nijmegen, Netherlands No competing interests were disclosed. Stephane Ranque, Aix Marseille University, IP-TPT, Marseille, France; Parasitologie & Mycologie, Hôpital de la Timone, Assistance Publique-Hôpitaux de Marseille, Marseille, France No competing interests were disclosed., , [version 1; referees: 2 approved]
- Publication Type :
- Academic Journal
- Accession number :
- edsfor.10.12688.f1000research.10216.1
- Document Type :
- review
- Full Text :
- https://doi.org/10.12688/f1000research.10216.1