Diagnosis of chronic disseminated candidosis from liver biopsies by a novel PCR in patients with haematological malignancies
Diagnosis of chronic disseminated candidosis from liver biopsies by a novel PCR in patients with haematological malignancies
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DOI：
10.1111/j.1469-0691.2011.03713.x
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发表时间：
2012-10-01
影响因子：
14.2
通讯作者：
Ruhnke, M.
中科院分区：
文献类型：
--
作者：
Fleischhacker, M.;Schulz, S.;Ruhnke, M.
临床微生物感染2012；肝念珠菌感染（HCI，俗称慢性弥散性念珠菌病或CDC）是一种独特形式的弥散性念珠菌感染，主要累及肝脏。HCI的诊断通常是在临床怀疑以及超声（US）、CT和/或MRI扫描肝脏多发病变的情况下做出的。真菌成分在肝组织中可能并不总是可见的，而真菌学培养通常是阴性的，这使得证实真菌疾病的证据变得困难。我们研究了一种新的商用低成本和密度阵列（LCD）芯片技术，用于HCI的分子诊断。这是一个两步的过程，DNA提取后进行PCR扩增，然后在制造商提供的小芯片上进行杂交（Fungi 2.1, Chipron GmbH）。对45株对照菌的DNA分析显示了良好的特异性和敏感性。在LCD芯片上对11例血液学恶性肿瘤合并CDC的肝活检组织进行DNA分析，8例肝活检组织共检出11种真菌病原体，支持HCI/CDC的临床诊断。所有研究样本的肝脏活检分析均为真菌DNA阴性。总之，我们研究中检测的新型LCD芯片技术能够在血液恶性肿瘤和疑似HCI/CDC患者的肝脏活检中检测到真菌病原体，但在对照活检中呈阴性。
Clin Microbiol Infect 2012; 18: 10101016 Abstract Hepatic Candida infection (HCI; known as chronic disseminated candidosis or CDC) is a distinct form of disseminated Candida infection with predominant involvement of the liver. Diagnosis of HCI is usually made on clinical suspicion together with multiple lesions in liver on ultrasound (US), CT and/or MRI scan. Fungal elements may not always be visible in liver tissue and mycological culture is frequently negative, making the evidence for proven fungal disease difficult. We studied a novel commercially available low-cost and density-array (LCD) chip technique for a molecular diagnosis of HCI. This is a two-step procedure with PCR amplification after DNA extraction followed by hybridization on a small chip provided by the manufacturer (Fungi 2.1, Chipron GmbH). The analysis of DNA from 45 fungal control strains showed an excellent specificity and sensitivity. The DNA from 11 liver biopsies of patients with haematological malignancies suffering from CDC was analysed on the LCD chip and overall 11 fungal pathogens could be detected in eight liver biopsies, supporting the clinical diagnosis of HCI/CDC. Analysis of liver biopsies from controls was negative for fungal DNA in all samples studied. In conclusion, the novel LCD chip technique examined in our study was able to detect fungal pathogens in liver biopsies from patients with haematological malignancies and suspected HCI/CDC but was negative in control biopsies.