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Fernández NB, Toranzo A, Farias L, Canteros CE. Mycological diagnosis of paracoccidioidomycosis in a hospital from a nonendemic area: classical and molecular methods. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2023; 43:132-143. [PMID: 37721907 PMCID: PMC10569774 DOI: 10.7705/biomedica.6888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/05/2023] [Indexed: 09/20/2023]
Abstract
Introduction Paracoccidioidomycosis is a systemic mycosis endemic in Latin America. Climate change and host migration emphasize the need to optimize this infection diagnosis. Objective To evaluate the implementation of Paracoccidioides spp. DNA detection in the mycological diagnosis of patients with suspected paracoccidioidomycosis. Materials and methods It is a retrospective study with laboratory data from patients with clinical suspicion of paracoccidioidomycosis, who consulted a university hospital from a non-endemic area. Results We analyzed the laboratory results of samples from 19 patients with suspected paracoccidioidomycosis. Seventeen out of 19 patients were born in or had visited an endemic area in Latin America. Fourteen adult male patients were confirmed to have paracoccidioidomycosis by conventional diagnosis: the direct examination was positive in 12 samples while fungal growth was found only in 4. Anti-Paracoccidioides spp. antibodies were detected in 10 patients, 8 of them with proven paracoccidioidomycosis. Nested PCR for Paracoccidioides spp. detection was performed on clinical samples from 14 patients, and positive results were obtained for 9 out of 10 patients with the conventional diagnosis of paracoccidioidomycosis. Conclusions The incorporation of molecular techniques to detect Paracoccidioides spp. DNA complements the conventional diagnosis of paracoccidioidomycosis. This tool allows the prescription of antifungal treatment in those cases where the fungus is not observed in the clinical samples.
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Affiliation(s)
- Norma B Fernández
- Laboratorio de Micología, Hospital de Clínicas "José de San Martín", Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.
| | - Adriana Toranzo
- Servicio Micosis Profundas, Departamento de Micología, INEI-ANLIS "Dr. Carlos G. Malbrán", Ciudad Autónoma de Buenos Aires, Argentina.
| | - Luciana Farias
- Laboratorio de Micología, Hospital de Clínicas "José de San Martín", Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.
| | - Cristina E Canteros
- Departamento de Micología, INEI-ANLIS "Dr. Carlos G. Malbrán", Ciudad Autónoma de Buenos Aires, Argentina.
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Tirado-Sánchez A, González GM, Bonifaz A. Endemic mycoses: epidemiology and diagnostic strategies. Expert Rev Anti Infect Ther 2020; 18:1105-1117. [PMID: 32620065 DOI: 10.1080/14787210.2020.1792774] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The global frequency of endemic mycoses has considerably increased, mainly due to environmental changes, population growth in endemic areas, and the increase in HIV-related immunosuppressed status. Among the most frequent endemic mycoses are coccidioidomycosis in semi-desert climates, and paracoccidioidomycosis, and histoplasmosis in tropical climates. The inoculum can enter the host through the airway or directly through the skin. Lymphatic and hematogenous spread may involve the skin. AREAS COVERED In this article, we provide up-to-date epidemiological and diagnostic data on major (histoplasmosis, paracoccidioidomycosis, coccidioidomycosis, blastomycosis) and minor (talaromycosis, adiaspiromycosis, emergomycosis) endemic mycoses. EXPERT OPINION Endemic mycoses include diseases with a localized endemic area, and a few of them converge. These mycoses all have in common the airway involvement and can cause pulmonary symptoms following initial asymptomatic infection. Among the risk groups to acquire these mycoses are travelers from endemic areas, archeologists, speleologists, and immigrants. Promising and useful diagnostic tools have been developed in endemic mycoses; however, most of them are not standardized or available in low-income countries.
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Affiliation(s)
- Andrés Tirado-Sánchez
- Dermatology Service, Hospital General De México "Dr. Eduardo Liceaga" , Mexico City, CP, Mexico.,Internal Medicine Department, Hospital General De Zona 29, Instituto Mexicano Del Seguro Social ., Mexico City, CP, Mexico
| | - Gloria M González
- Departamento De Microbiología, Facultad De Medicina, Universidad Autónoma De Nuevo León , San Nicolas De Los Garza, Mexico
| | - Alexandro Bonifaz
- Dermatology Service, Hospital General De México "Dr. Eduardo Liceaga" , Mexico City, CP, Mexico.,Mycology Department, Hospital General De México "Dr. Eduardo Liceaga" , Mexico City, CP, Mexico
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3
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Shell K, Rijkenhuizen A. Extensive and invasive guttural pouch granuloma in a 2‐year‐old gelding. EQUINE VET EDUC 2020. [DOI: 10.1111/eve.12955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- K. Shell
- Pferdeklinik Leichlingen GmbH Leichlingen Germany
| | - A. Rijkenhuizen
- Veterinary Clinic Duurstede Wijk bij Duurstede The Netherlands
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Frequency of Invasive Fungal Disease in Adults: Experience of a Specialized Laboratory in Medellín, Colombia (2009-2015). J Fungi (Basel) 2020; 6:jof6010039. [PMID: 32244949 PMCID: PMC7151061 DOI: 10.3390/jof6010039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 03/04/2020] [Accepted: 03/09/2020] [Indexed: 10/27/2022] Open
Abstract
Invasive fungal diseases (IFD) contribute significantly to worldwide morbidity and mortality, but their frequency is not well-described in some countries. The present work describes the frequency of IFD in a specialized laboratory in Colombia. A retrospective, descriptive study was implemented between March 2009 and December 2015. Results: 13,071 patients with clinical suspicion of IFD were referred during the study period, from which 33,516 biological samples were processed and analyzed using 14 laboratory methods. Diagnosis was confirmed in 1425 patients (11%), distributed according to the mycoses of interest analyzed here: histoplasmosis in 641/11,756 patients (6%), aspergillosis in 331/10,985 patients (3%), cryptococcosis in 239/8172 patients (3%), pneumocystosis in 111/1651 patients (7%), paracoccidioidomycosis in 60/10,178 patients (0.6%), and invasive candidiasis in 48/7525 patients (0.6%). From the first year of the study period to the last year, there was a 53% increase in the number of cases of IFD diagnosed. Our laboratory experienced a high frequency of IFD diagnosis, possibly attributable to the availability of a greater range of diagnostic tools. Frequency of IFD in this study was atypical compared with other studies, probably as a result of the single laboratory-site analysis. This demonstrates that implementing educational strategies helps to create a high index of clinical suspicion, while the availability and utilization of appropriate diagnostic assays assure greater reliability in identification of these cases.
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The Manaus Declaration: Current Situation of Histoplasmosis in the Americas, Report of the II Regional Meeting of the International Histoplasmosis Advocacy Group. CURRENT FUNGAL INFECTION REPORTS 2019. [DOI: 10.1007/s12281-019-00365-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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6
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Affiliation(s)
- Abdelaziz Ghanemi
- Key Laboratory of Animal Models and Human Disease Mechanisms, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650223, Yunnan Province, China
- University of Chinese Academy of Sciences, Beijing, 10049, China
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Bennett PF, Talbot JJ, Martin P, Kidd SE, Makara M, Barrs VR. Long term survival of a dog with disseminated Aspergillus deflectus infection without definitive treatment. Med Mycol Case Rep 2018; 22:1-3. [PMID: 30456161 PMCID: PMC6235754 DOI: 10.1016/j.mmcr.2018.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 07/09/2018] [Indexed: 11/24/2022] Open
Abstract
Canine disseminated fungal infection by Aspergillus species carries a guarded to grave prognosis as they often rapidly progress and are refractory to treatment with many euthanased soon after diagnosis. This case report describes a 2.5 year old female spayed German Shepherd Dog diagnosed with disseminated Aspergillus deflectus infection for which definitive treatment was declined by the owners. With only palliative management the dog survived three years and two months before succumbing to chronic kidney disease.
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Affiliation(s)
- Peter F Bennett
- Sydney School of Veterinary Science, Faculty of Science, Evelyn Williams Building B10, University of Sydney, NSW 2006, Australia
| | - Jessica J Talbot
- Sydney School of Veterinary Science, Faculty of Science, Evelyn Williams Building B10, University of Sydney, NSW 2006, Australia
| | - Patricia Martin
- Veterinary Pathology Diagnostic Service, Sydney School of Veterinary Science, Faculty of Science, Evelyn Williams Building B10, University of Sydney, NSW 2006, Australia
| | - Sarah E Kidd
- National Mycology Reference Centre, Microbiology and Infectious Diseases, SA Pathology, Frome Road, Adelaide, SA 5000, Australia
| | - Mariano Makara
- Sydney School of Veterinary Science, Faculty of Science, Evelyn Williams Building B10, University of Sydney, NSW 2006, Australia
| | - Vanessa R Barrs
- Sydney School of Veterinary Science, Faculty of Science, Evelyn Williams Building B10, University of Sydney, NSW 2006, Australia.,Marie Bashir Institute of Infectious Diseases and Biosecurity, University of Sydney, NSW 2006, Australia
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Chen SCA, Meyer W, Pashley CH. Challenges in Laboratory Detection of Fungal Pathogens in the Airways of Cystic Fibrosis Patients. Mycopathologia 2017; 183:89-100. [PMID: 28589247 DOI: 10.1007/s11046-017-0150-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Accepted: 05/20/2017] [Indexed: 12/11/2022]
Abstract
Study of the clinical significance of fungal colonization/infection in the airways of cystic fibrosis (CF) patients, especially by filamentous fungi, is challenged by the absence of standardized methodology for the detection and identification of an ever-broadening range of fungal pathogens. Culture-based methods remain the cornerstone diagnostic approaches, but current methods used in many clinical laboratories are insensitive and unstandardized, rendering comparative studies unfeasible. Guidelines for standardized processing of respiratory specimens and for their culture are urgently needed and should include recommendations for specific processing procedures, inoculum density, culture media, incubation temperature and duration of culture. Molecular techniques to detect fungi directly from clinical specimens include panfungal PCR assays, multiplex or pathogen-directed assays, real-time PCR, isothermal methods and probe-based assays. In general, these are used to complement culture. Fungal identification by DNA sequencing methods is often required to identify cultured isolates, but matrix-assisted laser desorption/ionization time-of-flight mass spectrometry is increasingly used as an alternative to DNA sequencing. Genotyping of isolates is undertaken to investigate relatedness between isolates, to pinpoint the infection source and to study the population structure. Methods range from PCR fingerprinting and amplified fragment length polymorphism analysis, to short tandem repeat typing, multilocus sequencing typing (MLST) and whole genome sequencing (WGS). MLST is the current preferred method, whilst WGS offers best case resolution but currently is understudied.
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Affiliation(s)
- Sharon C-A Chen
- Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR - Pathology West, Westmead Hospital, 3rd Level ICPMR Building, Westmead, NSW, 2145, Australia.
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Sydney Medical School, The University of Sydney, Westmead Hospital, Westmead Institute for Medical Research, Westmead, NSW, Australia.
| | - Wieland Meyer
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Sydney Medical School, The University of Sydney, Westmead Hospital, Westmead Institute for Medical Research, Westmead, NSW, Australia
- Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, NSW, Australia
| | - Catherine H Pashley
- Department of Infection, Immunity and Inflammation, Institute for Lung Health, University of Leicester, Leicester, LE1 9HN, UK
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Paulussen C, Hallsworth JE, Álvarez‐Pérez S, Nierman WC, Hamill PG, Blain D, Rediers H, Lievens B. Ecology of aspergillosis: insights into the pathogenic potency of Aspergillus fumigatus and some other Aspergillus species. Microb Biotechnol 2017; 10:296-322. [PMID: 27273822 PMCID: PMC5328810 DOI: 10.1111/1751-7915.12367] [Citation(s) in RCA: 177] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 04/08/2016] [Accepted: 04/18/2016] [Indexed: 01/26/2023] Open
Abstract
Fungi of the genus Aspergillus are widespread in the environment. Some Aspergillus species, most commonly Aspergillus fumigatus, may lead to a variety of allergic reactions and life-threatening systemic infections in humans. Invasive aspergillosis occurs primarily in patients with severe immunodeficiency, and has dramatically increased in recent years. There are several factors at play that contribute to aspergillosis, including both fungus and host-related factors such as strain virulence and host pulmonary structure/immune status, respectively. The environmental tenacity of Aspergilllus, its dominance in diverse microbial communities/habitats, and its ability to navigate the ecophysiological and biophysical challenges of host infection are attributable, in large part, to a robust stress-tolerance biology and exceptional capacity to generate cell-available energy. Aspects of its stress metabolism, ecology, interactions with diverse animal hosts, clinical presentations and treatment regimens have been well-studied over the past years. Here, we synthesize these findings in relation to the way in which some Aspergillus species have become successful opportunistic pathogens of human- and other animal hosts. We focus on the biophysical capabilities of Aspergillus pathogens, key aspects of their ecophysiology and the flexibility to undergo a sexual cycle or form cryptic species. Additionally, recent advances in diagnosis of the disease are discussed as well as implications in relation to questions that have yet to be resolved.
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Affiliation(s)
- Caroline Paulussen
- Laboratory for Process Microbial Ecology and Bioinspirational Management (PME&BIM)Department of Microbial and Molecular Systems (M2S)KU LeuvenCampus De NayerSint‐Katelijne‐WaverB‐2860Belgium
| | - John E. Hallsworth
- Institute for Global Food SecuritySchool of Biological SciencesMedical Biology CentreQueen's University BelfastBelfastBT9 7BLUK
| | - Sergio Álvarez‐Pérez
- Faculty of Veterinary MedicineDepartment of Animal HealthUniversidad Complutense de MadridMadridE‐28040Spain
| | | | - Philip G. Hamill
- Institute for Global Food SecuritySchool of Biological SciencesMedical Biology CentreQueen's University BelfastBelfastBT9 7BLUK
| | - David Blain
- Institute for Global Food SecuritySchool of Biological SciencesMedical Biology CentreQueen's University BelfastBelfastBT9 7BLUK
| | - Hans Rediers
- Laboratory for Process Microbial Ecology and Bioinspirational Management (PME&BIM)Department of Microbial and Molecular Systems (M2S)KU LeuvenCampus De NayerSint‐Katelijne‐WaverB‐2860Belgium
| | - Bart Lievens
- Laboratory for Process Microbial Ecology and Bioinspirational Management (PME&BIM)Department of Microbial and Molecular Systems (M2S)KU LeuvenCampus De NayerSint‐Katelijne‐WaverB‐2860Belgium
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10
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Carrasco-Zuber J, Navarrete-Dechent C, Bonifaz A, Fich F, Vial-Letelier V, Berroeta-Mauriziano D. Cutaneous involvement in the Deep Mycoses: A Review. Part II—Systemic Mycoses. ACTAS DERMO-SIFILIOGRAFICAS 2016. [DOI: 10.1016/j.adengl.2016.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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11
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Carrasco-Zuber J, Navarrete-Dechent C, Bonifaz A, Fich F, Vial-Letelier V, Berroeta-Mauriziano D. Afectación cutánea en las micosis profundas: una revisión de la literatura. Parte 2. Micosis sistémicas. ACTAS DERMO-SIFILIOGRAFICAS 2016; 107:816-822. [DOI: 10.1016/j.ad.2016.06.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 05/29/2016] [Indexed: 01/13/2023] Open
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12
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Brilhante RSN, Bittencourt PV, Lima RAC, Castelo-Branco D, Oliveira JS, Pinheiro A, Cordeiro R, Camargo ZP, Sidrim JJC, Rocha MFG. Coccidioidomycosis and Histoplasmosis in Equines: An Overview to Support the Accurate Diagnosis. J Equine Vet Sci 2016. [DOI: 10.1016/j.jevs.2016.02.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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13
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Abstract
Rapid, accurate diagnostic laboratory tests are needed to improve clinical outcomes of invasive fungal disease (IFD). Traditional direct microscopy, culture and histological techniques constitute the 'gold standard' against which newer tests are judged. Molecular diagnostic methods, whether broad-range or fungal-specific, have great potential to enhance sensitivity and speed of IFD diagnosis, but have varying specificities. The use of PCR-based assays, DNA sequencing, and other molecular methods including those incorporating proteomic approaches such as matrix-assisted laser desorption ionisation-time of flight mass spectroscopy (MALDI-TOF MS) have shown promising results. These are used mainly to complement conventional methods since they require standardisation before widespread implementation can be recommended. None are incorporated into diagnostic criteria for defining IFD. Commercial assays may assist standardisation. This review provides an update of molecular-based diagnostic approaches applicable to biological specimens and fungal cultures in microbiology laboratories. We focus on the most common pathogens, Candida and Aspergillus, and the mucormycetes. The position of molecular-based approaches in the detection of azole and echinocandin antifungal resistance is also discussed.
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Could Histoplasma capsulatum Be Related to Healthcare-Associated Infections? BIOMED RESEARCH INTERNATIONAL 2015; 2015:982429. [PMID: 26106622 PMCID: PMC4461736 DOI: 10.1155/2015/982429] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 05/12/2015] [Accepted: 05/12/2015] [Indexed: 02/07/2023]
Abstract
Healthcare-associated infections (HAI) are described in diverse settings. The main etiologic agents of HAI are bacteria (85%) and fungi (13%). Some factors increase the risk for HAI, particularly the use of medical devices; patients with severe cuts, wounds, and burns; stays in the intensive care unit, surgery, and hospital reconstruction works. Several fungal HAI are caused by Candida spp., usually from an endogenous source; however, cross-transmission via the hands of healthcare workers or contaminated devices can occur. Although other medically important fungi, such as Blastomyces dermatitidis, Paracoccidioides brasiliensis, and Histoplasma capsulatum, have never been considered nosocomial pathogens, there are some factors that point out the pros and cons for this possibility. Among these fungi, H. capsulatum infection has been linked to different medical devices and surgery implants. The filamentous form of H. capsulatum may be present in hospital settings, as this fungus adapts to different types of climates and has great dispersion ability. Although conventional pathogen identification techniques have never identified H. capsulatum in the hospital environment, molecular biology procedures could be useful in this setting. More research on H. capsulatum as a HAI etiologic agent is needed, since it causes a severe and often fatal disease in immunocompromised patients.
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Teles F, Seixas J. The future of novel diagnostics in medical mycology. J Med Microbiol 2014; 64:315-322. [PMID: 25418735 DOI: 10.1099/jmm.0.082297-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Accepted: 11/17/2014] [Indexed: 11/18/2022] Open
Abstract
Several fungal diseases have become serious threats to human health and life, especially upon the advent of human immunodeficiency virus/AIDS epidemics and of other typical immunosuppressive conditions of modern life. Accordingly, the burden posed by these diseases and, concurrently, by intensive therapeutic regimens against these diseases has increased worldwide. Existing and available rapid tests for point-of-care diagnosis of important fungal diseases could enable the limitations of current laboratory methods for detection and identification of medically important fungi to be surpassed, both in low-income countries and for first-line diagnosis (screening) in richer countries. As with conventional diagnostic methods and devices, former immunodiagnostics have been challenged by molecular biology-based platforms, as a way to enhance the sensitivity and shorten the assay time, thus enabling early and more accurate diagnosis. Most of these tests have been developed in-house, without adequate validation and standardization. Another challenge has been the DNA extraction step, which is especially critical when dealing with fungi. In this paper, we have identified three major research trends in this field: (1) the application of newer biorecognition techniques, often applied in analytical chemistry; (2) the development of new materials with improved physico-chemical properties; and (3) novel bioanalytical platforms, allowing fully automated testing. Keeping up to date with the fast technological advances registered in this field, primarily at the proof-of-concept level, is essential for wise assessment of those that are likely to be more cost effective and, as already observed for bacterial and viral pathogens, may provide leverage to the current tepid developmental status of novel and improved diagnostics for medical mycology.
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Affiliation(s)
- Fernando Teles
- Centre for Malaria and Other Tropical Diseases, Institute of Hygiene and Tropical Medicine, Universidade Nova de Lisboa, 100 Rua da Junqueira, 1349-008 Lisbon, Portugal.,Mycology Group/Unit of Medical Microbiology, Institute of Hygiene and Tropical Medicine, Universidade Nova de Lisboa, 100 Rua da Junqueira, 1349-008 Lisbon, Portugal
| | - Jorge Seixas
- Tropical Clinic Unit, Institute of Hygiene and Tropical Medicine (IHMT), Universidade Nova de Lisboa, 100 Rua da Junqueira, 1349-008 Lisbon, Portugal.,Centre for Malaria and Other Tropical Diseases, Institute of Hygiene and Tropical Medicine, Universidade Nova de Lisboa, 100 Rua da Junqueira, 1349-008 Lisbon, Portugal
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Scheel CM, Gómez BL. Diagnostic Methods for Histoplasmosis: Focus on Endemic Countries with Variable Infrastructure Levels. CURRENT TROPICAL MEDICINE REPORTS 2014; 1:129-137. [PMID: 31187020 DOI: 10.1007/s40475-014-0020-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Diagnosis of histoplasmosis remains challenging in resource-limited regions where HIV/AIDS is epidemic and histoplasmosis is endemic. Early and rapid detection of histoplasmosis is essential to preventing morbidity and mortality, yet few diagnostic options are available in low-resource areas of the world. The aim of this review is to provide an overview of the current status of the diagnosis of histoplasmosis, including an update on recent developments and utilization of new technologies. We discuss the specific diagnostic challenges faced in endemic regions, emphasizing the need for greater availability and standardization of rapid diagnostics for this endemic and neglected disease. While significant progress has been made in the development of new methods, clinical utility must be established by means of formal and extensive clinical studies.
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Affiliation(s)
- Christina M Scheel
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS G11, Atlanta, GA, USA
| | - Beatriz L Gómez
- Corporación para Investigaciones Biólogicas, Cra. 72 No 78 B 141, Medellín, Colombia
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