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Advances and Prospects for Molecular Diagnostics of Fungal Infections

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Abstract

The polymerase chain reaction (PCR) methods published for the diagnosis of invasive fungal infections are still not included in the revised European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group definitions of IA. This could be achieved with consensual PCR procedures. A checklist of items has been proposed to improve the reliability of the results and clinicians’ confidence in them, with emphasis on limiting false-positive results from contamination with either previously amplified products or environmental commensals. Internal amplification controls are mandatory to expose false-negative results. However, our ignorance of the origin and the kinetics of fungal DNA during an infection hamper the choice of the best specimen and DNA extraction protocol. Evidence is increasing that serum could be a good compromise between sensitivity and ease of DNA extraction. Once a technical consensus is achieved, clinical studies should be initiated to integrate quantitative PCR in the diagnostic armamentarium.

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Acknowledgments

I thank Dr. Gillian Barrat for her critical reading of the manuscript.

Disclosure

The author has served as a consultant for Myconostica and for Gilead; received payment for providing expert testimony for Agence Francaise de Securite Sanitaire des Produits de Sante (AFSSAPS, the French agency for drug safety); received honoraria from Gilead and Pfizer; and served on the speakers’ bureau for Gilead. In addition, the author’s institution has received grants from Pfizer.

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Authors and Affiliations

  1. Groupe hospitalier Chenevier-Mondor, APHP, Laboratoire de Parasitologie-Mycologie, Créteil, France

    Stéphane Bretagne

  2. Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence de Mycologie et des Antifongiques, Paris, France

    Stéphane Bretagne

  3. Université Paris Est-Créteil, UMR BIPAR 956, Créteil, France

    Stéphane Bretagne

  4. Laboratoire de Parasitologie-Mycologie, Hôpital Henri Mondor-APHP, 41 Avenue du Maréchal DeLattre de Tassigny, Créteil, 94010, France

    Stéphane Bretagne

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  1. Stéphane Bretagne
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Correspondence to Stéphane Bretagne.

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Bretagne, S. Advances and Prospects for Molecular Diagnostics of Fungal Infections. Curr Infect Dis Rep 12, 430–436 (2010). https://doi.org/10.1007/s11908-010-0139-7

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