Towards a molecular diagnosis of invasive aspergillosis and disseminated candidosis
Towards a molecular diagnosis of invasive aspergillosis and disseminated candidosis
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DOI：
10.1016/j.femsim.2005.05.012
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发表时间：
2005-09-01
影响因子：
--
通讯作者：
Costa, JM
中科院分区：
文献类型：
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作者：
Bretagne, S;Costa, JM
目前已有大量的聚合酶链反应技术用于侵袭性曲霉病和播散性念珠菌病的诊断。令人鼓舞的结果已经发表，以预测诊断超过传统的微生物方法。然而，由于缺乏标准化的方法，导致了不同的结果。因此，与一些抗原血症检测试剂盒相比，这些测试不被认为是一致的诊断标准。改善这些方法结果的主要突破是实时技术的出现。这显著提高了PCR结果的可靠性，大大降低了由于PCR产物残留而导致的假阳性结果的风险。此外，使用该技术提供的定量结果，这允许快速比较引物、探针和DNA提取方法的效率。因此，希望确定更具体和敏感的参数，以进行比较研究。自动化DNA提取也应该有助于实现这一目标。无论使用什么复杂的技术，我们仍然需要定义在给定的临床样本中检测核酸的含义。这在正常无菌的解剖部位似乎很简单，但不太明显，例如在侵袭性曲霉病的呼吸道标本中或在大量定植患者的念珠菌病的血液中。需要对真菌DNA的动力学进行进一步的研究。实时技术的发展应该提高我们的知识，以便为临床医生提供决策的信息线索。(c)2005年欧洲微生物学会联合会由Elsevier B.V.出版，保留所有权利。
A lot of in-house polymerase chain reaction assays have been reported for diagnosis of invasive aspergillosis and disseminated candidosis. Encouraging results have been published to anticipate the diagnosis over the conventional microbiological methods. However, the absence of standardized methods has led to diverging results. As a consequence, these tests are not recognized as consensual diagnostic criteria, in contrast with some antigenemia detection kits. The major breakthrough for improving the results of these methods is the emergence of real-time technologies. This markedly improves the reliability of the PCR results by dramatically decreasing the risk of false positive results due to PCR products carryover. Moreover, using the quantitative results provided by this technique, this allows to rapidly compare the efficiency of primers, probes, and DNA extraction methods. Therefore, the hope is to identify the more specific and sensitive parameters to implement comparative studies. Automated DNA extraction should also be useful to achieve this goal.Whatever sophisticated technology is used, we still have to define the meaning of detecting nucleic acids in a given clinical sample. This seems simple in normally sterile anatomical sites but less obvious for example in respiratory specimens for invasive aspergillosis or in blood for candidosis in heavily colonized patients. Additional studies of the kinetics of fungal DNA are needed. The development of real-time technology should improve our knowledge in order to give the clinicians informative clues for making a decision. (c) 2005 Federation of European Microbiological Societies Published by Elsevier B.V. All rights reserved.