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Performance of Mucorales spp. qPCR in bronchoalveolar lavage fluid for the diagnosis of pulmonary mucormycosis.
Brousse, Xavier; Imbert, Sébastien; Issa, Nahéma; Forcade, Edouard; Faure, Maxime; Chambord, Jeremy; Ramaroson, Hanta; Kaminski, Hannah; Dumas, Pierre-Yves; Blanchard, Elodie.
Afiliação
  • Brousse X; Service des maladies infectieuses & tropicales, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France.
  • Imbert S; Service de Parasitologie-Mycologie, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France.
  • Issa N; Médecine intensive réanimation, Hôpital Saint-André, CHU de Bordeaux, Bordeaux, France.
  • Forcade E; Service d'hématologie et de thérapie cellulaire, Hôpital Haut-Lévêque CHU de Bordeaux, Pessac, France.
  • Faure M; Service de traitement de l'insuffisance cardiaque, de l'HTAP et de suivi des greffes et assistances cardiaques, Hôpital Haut-Lévêque, CHU de Bordeaux, Pessac, France.
  • Chambord J; Pharmacie à usage intérieure, Hôpital Haut-Lévêque, CHU de Bordeaux, Pessac, France.
  • Ramaroson H; Unité de Coordination et d'Analyse de l'Information Médicale - Département d'Information Médicale (UCAIM-DIM), CHU de Bordeaux, Bordeaux, France.
  • Kaminski H; Service de Néphrologie, Transplantation Dialyse, Aphérèses, Hôpital Pellegrin, Bordeaux, France.
  • Dumas PY; Service d'hématologie et de thérapie cellulaire, Hôpital Haut-Lévêque CHU de Bordeaux, Pessac, France.
  • Blanchard E; Service de Pneumologie, Hôpital Haut-Lévêque, CHU de Bordeaux, Pessac, France.
Med Mycol ; 62(2)2024 Jan 27.
Article em En | MEDLINE | ID: mdl-38289831
ABSTRACT
To estimate the diagnostic performance of Mucorales polymerase chain reaction (PCR) in Bronchoalveolar lavage fluid (BALF) in routine practice. This was a single-center retrospective study including all consecutive patients >18 years who underwent Mucorales PCR assay in BALF between January 2021 and May 2022. Index testing was prospectively performed using the MycoGENIE Aspergillus spp.-Mucorales spp. PCR. The reference was the diagnosis of pulmonary mucormycosis by the Adjudication Committee. Mucorales PCR in BALF was performed for 938 patients and was positive for 21 of 938 (2.2%). Eleven pulmonary mucormycosis (including one disseminated) were diagnosed. Among them, one (9.1%) was classified as proven mucormycosis, three (27.3%) as probable, and seven (63.6%) as possible according to the EORTC/MSGERC 2019 criteria. The main host factor was hematological malignancy (10 of 11, 90.9%). Mucorales PCR was positive in serum for eight patients (72.7%). Three patients had positive PCR in BALF, but negative in serum. The mean cycle threshold value was significantly lower in mucormycosis than false-positive cases. Sensitivity was 72.7% (95% confidence interval [CI], 43.4-90.3%), and specificity was 98.6% (95% CI, 97.6-99.2%). The positive and negative predictive values were 38.1% (95% CI, 20.8-59.1%) and 99.7% (95% CI, 99.1-99.9%), respectively. Mucorales PCR in BALF showed good diagnostic performance for mucormycosis, particularly in combination with serum PCR. A positive result should be interpreted with caution, given the possibility of carriage in the airway. However, its high negative predictive value and specificity suggest the utility of Mucorales PCR in BALF in the diagnosis of pulmonary mucormycosis.
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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 Limite: Humans Idioma: En Revista: Med Mycol Assunto da revista: MEDICINA VETERINARIA / MICROBIOLOGIA Ano de publicação: 2024 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 Limite: Humans Idioma: En Revista: Med Mycol Assunto da revista: MEDICINA VETERINARIA / MICROBIOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: França