Roles of the multiplex real-time PCR assay and β-D-glucan in a high-risk population for intra-abdominal candidiasis (IAC). (7th December 2019)

• Record Type: Journal Article
• Authors: Fortún, J; Buitrago, M J; Gioia, F; Gómez-Gª de la Pedrosa, E; Alvarez, M E; Martín-Dávila, P; Pintado, V; Cobeta, P; Martinez-Castro, N; Soriano, C; Moreno, I; Corral, S; Muñoz, P; Moreno-Jimenez, G; Cuenca-Estrella, M; Moreno-Guillen, S
• Is Part Of: Medical mycology. Volume 58:Number 6(2020)
• Page Start: 789
• Page End: 796
• Publication Date: 2019-12-07
• Subjects: multiplex PCR -- Candida spp -- peritonitis; Medical mycology -- Periodicals; Veterinary mycology -- Periodicals; Mycology -- Periodicals; Mycoses -- Periodicals; Pathogenic fungi -- Periodicals; 616.969005
• DOI: 10.1093/mmy/myz123
• Languages: English
• ISSNs: 1369-3786

Abstract

Abstract: Multiplex quantitative real-time PCR (MRT-PCR) using blood can improve the diagnosis of intra-abdominal candidiasis (IAC). We prospectively studied 39 patients with suspected IAC in the absence of previous antifungal therapy. Blood cultures, MRT-PCR, and β-D-glucan (BDG) in serum were performed in all patients. IAC was defined according to the 2013 European Consensus criteria. For MRT-PCR, the probes targeted the ITS1 or ITS2 regions of ribosomal DNA. Candidaemia was confirmed only in four patients (10%), and IAC criteria were present in 17 patients (43.6%). The sensitivity of MRT-PCR was 25% but increased to 63.6% ( P = .06) in plasma obtained prior to volume overload and transfusion; specificity was above 85% in all cases. BDG performance was improved using a cutoff > 260 pg/ml, and improvement was not observed in samples obtained before transfusion. In this cohort of high risk of IAC and low rate of bloodstream infection, the performance of non-culture-based methods (MRT-PCR or BDG) was moderate but may be a complementary tool given the limitations of diagnostic methods available in clinical practice. Volume overload requirements, in combination with other factors, decrease the accuracy of MRT-PCR in patients with IAC.