Fungal infections diagnosed in patients of haematological department

Ref ID: 17704

Author:

U. Nawrot*, L. Usnarska-Zubkiewicz, K. Wlodarczyk, M. Wrobel,
K. Kuliczkowski, G. Gosciniak

Author address:

(Wroclaw, PL)

Full conference title:

22nd European Congress of Clinical Microbiology and Infectious Diseases

Abstract:

The aim of this study was to test the utility of the detection of
Aspergillus GM and fungal DNA in blood samples from patients with
clinical signs of infection.
Methods: Within the period of 3 years 80 patients of the Department
of Haematology who were treated with conventional chemotherapy due
to leukaemia (40), lymphoma (7), multiple myeloma (8) or other
malignancies: CLL (17) MDS (8) were examined for the presence of
fungal biomarkers in the blood. The patients showed FUO or
abnormalities in respiratory tract and/or central nervous system
demonstrated in radiological examination. The laboratory
examinations included testing of Aspergillus galactomannan (GM) by
PlateliaTMAspergillus (BioRad, France) and investigation of fungal
DNA by previously described universal primers and Aspergillus- and
Candida- specific TaqMan probes (White et al., CID 2006; Khlif et al.
CMI 2009). DNA from EDTA-blood samples was extracted by
mechanical cell disruption and commercial test QIAmp DNA Mini
kit (Qiagen. The presence of PCR inhibitors was tested using the
TaqMan Exogenous IPC Reagents (Applied Biosystem).
Results: The multiple positive results of GM blood testing were
obtained in two patients with ALL, of them one was also positive for
Aspergillus DNA. Next three patients (two with ALL and one with MM
were positive in Aspergillus TaqMan, despite of negative GM results,
however clinical and radiological picture were in agreement with
positive TaqMan sample.
Candida DNA was detected in the blood from seven patients, no one of
them showed positive blood cultures, however in some patients
pneumonia was diagnosed based on clinical and radiological findings.
The patients were treated empirically with ketokonazol and voriconazol
with good outcome. The blood culture positive for fungi were found in
one patient with negative results of tested biomarkers. The causative
organism was identified biochemically and by sequencing of ribosomal
DNA as Trichosporon asahi. In the another patient (AML) the
mucormycosis was detected by the culture of Absidia corymbifera
from the respiratory tract. Applying the PCR with universal primers
followed by sequencing of PCR product enabled to detect the DNA of
this microorganism in patient’s blood sample.
Conclusion: Molecular examination of blood samples together with
molecular identification of cultured microorganisms seems to be an
useful tool improving the diagnosis of IFI in haematological patients.

Abstract Number: R2729

Conference Year: 2012

Link to conference website: NULL

New link: NULL

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