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Evaluation of Serum Mucorales Polymerase Chain Reaction (PCR) for the Diagnosis of Mucormycoses: The MODIMUCOR Prospective Trial.
Millon, Laurence; Caillot, Denis; Berceanu, Ana; Bretagne, Stéphane; Lanternier, Fanny; Morio, Florent; Letscher-Bru, Valérie; Dalle, Frédéric; Denis, Blandine; Alanio, Alexandre; Boutoille, David; Bougnoux, Marie Elisabeth; Botterel, Françoise; Chouaki, Taieb; Charbonnier, Amandine; Ader, Florence; Dupont, Damien; Bellanger, Anne Pauline; Rocchi, Steffi; Scherer, Emeline; Gbaguidi-Haore, Houssein; Herbrecht, Raoul.
Afiliação
  • Millon L; Laboratoire de Parasitologie-Mycologie, Centre hospitalier universtaire (CHU) Besançon, Besançon, France.
  • Caillot D; Unité mixte de recherche (UMR) 6249 Centre national de la recherche scientifique (CNRS) Chrono-Environnement, Univ Bourgogne Franche-Comté, Besançon, France.
  • Berceanu A; Department of Clinical Hematology, CHU Dijon, Dijon, France.
  • Bretagne S; Service d'Hematologie, CHU Besançon, Besançon, France.
  • Lanternier F; Institut Pasteur, CNRS, Molecular Mycology Unit, National Reference Center for Invasive Mycoses and Antifungals, UMR 2000, Paris, France.
  • Morio F; Laboratoire de Parasitologie-Mycologie, Hôpital Saint Louis, AP-HP, Paris, France.
  • Letscher-Bru V; Université de Paris, Paris, France.
  • Dalle F; Institut Pasteur, CNRS, Molecular Mycology Unit, National Reference Center for Invasive Mycoses and Antifungals, UMR 2000, Paris, France.
  • Denis B; Université de Paris, Paris, France.
  • Alanio A; Necker Pasteur Center for Infectious Diseases and Tropical Medicine, Hôpital Necker Enfants malades, AP-HP, Instituts Hôpitaux Universitaires (IHU) Imagine, Paris, France.
  • Boutoille D; Laboratoire de Parasitologie-Mycologie, CHU Nantes, Nantes, France.
  • Bougnoux ME; Département de Parasitologie et Mycologie Médicale, EA1155 - IICiMed, Nantes Université, Nantes, France.
  • Botterel F; Laboratoire de Parasitologie et de Mycologie Médicale, Hôpitaux Universitaires de Strasbourg, France.
  • Chouaki T; Laboratoire de Parasitologie-Mycologie, Plateforme de Biologie Hospitalo-Universitaire Gérard Mack, Dijon, France.
  • Charbonnier A; UMR PAM Univ Bourgogne Franche-Comté, AgroSup Dijon, Equipe Vin, Aliment, Microbiologie, Stress, Dijon, France.
  • Ader F; Infectious Diseases Department, APHP, Saint-Louis Hospital, Paris, France.
  • Dupont D; Institut Pasteur, CNRS, Molecular Mycology Unit, National Reference Center for Invasive Mycoses and Antifungals, UMR 2000, Paris, France.
  • Bellanger AP; Laboratoire de Parasitologie-Mycologie, Hôpital Saint Louis, AP-HP, Paris, France.
  • Rocchi S; Université de Paris, Paris, France.
  • Scherer E; Unité Maladies Infectieuses et Tropicales, CHU Nantes, Nantes, France.
  • Gbaguidi-Haore H; Parasitology-Mycology Unit, Necker Enfants Malades Hospital, APHP, Paris, France.
  • Herbrecht R; Fungal Biology and Pathogenicity Unit, INRA USC 2019, Institut Pasteur, Paris, France.
Clin Infect Dis ; 75(5): 777-785, 2022 09 14.
Article em En | MEDLINE | ID: mdl-34986227
BACKGROUND: Early diagnosis and prompt initiation of specific antifungal treatment are essential for improving the prognosis of mucormycosis. We aimed to assess the performance of serum Mucorales quantitative polymerase chain reaction (qPCR) for the early diagnosis and follow-up of mucormycosis. METHODS: We prospectively enrolled 232 patients with suspicion of invasive mold disease, evaluated using standard imaging and mycological procedures. Thirteen additional patients with proven or probable mucormycosis were included to analyze DNA load kinetics. Serum samples were collected twice-a-week for Mucorales qPCR tests targeting the Mucorales genera Lichtheimia, Rhizomucor, and Mucor/Rhizopus. RESULTS: The sensitivity was 85.2%, specificity 89.8%, and positive and negative likelihood ratios 8.3 and 0.17, respectively in this prospective study. The first Mucorales qPCR-positive serum was observed a median of 4 days (interquartile range [IQR], 0-9) before sampling of the first mycological or histological positive specimen and a median of one day (IQR, -2 to 6) before the first imaging was performed. Negativity of Mucorales qPCR within seven days after liposomal-amphotericin B initiation was associated with an 85% lower 30-day mortality rate (adjusted hazard ratio = 0·15, 95% confidence interval [.03-.73], P = .02). CONCLUSIONS: Our study argues for the inclusion of qPCR for the detection of circulating Mucorales DNA for mucormycosis diagnosis and follow-up after treatment initiation. Positive results should be added to the criteria for the consensual definitions from the European Organization for the Research and Treatment of Cancer/Mycoses Study Group Education and Research Consortium (EORTC/MSGERC), as already done for Aspergillus PCR.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Mucorales / Mucormicose Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Limite: Humans Idioma: En Revista: Clin Infect Dis Assunto da revista: DOENCAS TRANSMISSIVEIS Ano de publicação: 2022 Tipo de documento: Article País de afiliação: França

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Mucorales / Mucormicose Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Limite: Humans Idioma: En Revista: Clin Infect Dis Assunto da revista: DOENCAS TRANSMISSIVEIS Ano de publicação: 2022 Tipo de documento: Article País de afiliação: França