Enfermedad fúngica invasora: ¿Diagnóstico micológico convencional o molecular? / Invasive Fungal Disease: Conventional or molecular mycological diagnosis?

RESUMEN

El diagnóstico de las micosis invasoras es un reto difícil por la baja sensibilidad de los métodos tradicionales y conlleva retrasos diagnósticos y terapéuticos. Los objetivos de este trabajo de revisión han sido resumir el estado actual de las técnicas de diagnóstico molecular de las enfermedades fúngicas invasoras y aclarar el papel real que desempeñan en la práctica clínica. Los métodos microbiológicos convencionales pueden ser complementados con técnicas moleculares que permitan una identificación más rápida y certera de los aislamientos clínicos. La detección de biomarcadores (..)(AU)

ABSTRACT

Diagnosis of invasive mycoses is a difficult challenge due to the limitations and low sensitivity of traditional microbiology methods which lead to diagnostic and therapeutic delays. The aim of this review is to summarise the state of the art of the molecular diagnosis of invasive fungal disease and to clarify its current role in the clinical practice. Conventional microbiological methods could be complemented with molecular methods in the rapid and definitive identification of fungal isolates. Biomarkers ( -glucan, galactomannan) are very useful in immunocompromised patients and have been included as probable invasive mycoses by the EORTC/MSG. Nucleic acid detection is currently used as a complementary tool for diagnosis. However, PCR can be very useful in mould invasive mycoses. Finally, the combined detection using biomarkers can improve the diagnosis. However, their applicability in the microbiology laboratoryis not so easy and further studies are required for the appropriate evaluation of its clinical usefulness (AU)