Diagnosis of Invasive Fungal Diseases

A special issue of Journal of Fungi (ISSN 2309-608X). This special issue belongs to the section "Fungal Pathogenesis and Disease Control".

Deadline for manuscript submissions: 30 September 2024 | Viewed by 2129

Special Issue Editor


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Guest Editor
Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
Interests: diagnosis and management of infectious complications in immunocompromised patients, especially invasive fungal diseases; prevention of infectious diseases in procedures such as post-transplantation vaccination

Special Issue Information

Dear Colleagues,

Invasive fungal diseases are on the rise. The biggest reason for this is that the number of patients with a reduced immune function, such as patients with acute leukemia or undergoing transplantation, is increasing, and they suffer from invasive fungal diseases as opportunistic infections while surviving for a long time. Another reason is that in the past, diagnosis was only possible with extremely limited methods such as culture tests, and the yield of this test method was low, so diagnoses were not performed properly or promptly. New diagnostic methods such as PCR, MALDI-TOF, and lateral flow devices were developed, and methods that can use specimens other than blood—for example, bronchoalveolar lavage, urinalysis, etc.—are being tested. In addition, by applying these methods clinically, fungal diseases can be better understood and treated early. In addition, a kit that can not only diagnose fungal diseases but can also check antifungal resistance at the same time as diagnosis is being developed. The development and application of this new diagnostic method will lead to the early detection of invasive fungal diseases, which will lead to the early initiation of appropriate antifungal drugs, thereby improving patients’ outcomes.

This Special Issue introduces methods that were recently developed or are being developed for diagnosing invasive fungal diseases and shares the experiences of each hospital and center that have applied these methods clinically.

Dr. Dong-Gun Lee
Guest Editor

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Keywords

  • invasive fungal diseases
  • new diagnostic methods
  • antifungal resistance
  • PCR
  • rapid kit

Published Papers (2 papers)

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14 pages, 4357 KiB  
Article
Clinical Implementation of β-Tubulin Gene-Based Aspergillus Polymerase Chain Reaction for Enhanced Aspergillus Diagnosis in Patients with Hematologic Diseases: A Prospective Observational Study
by Raeseok Lee, Won-Bok Kim, Sung-Yeon Cho, Dukhee Nho, Chulmin Park, In Young Yoo, Yeon-Joon Park and Dong-Gun Lee
J. Fungi 2023, 9(12), 1192; https://0-doi-org.brum.beds.ac.uk/10.3390/jof9121192 - 13 Dec 2023
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Abstract
The β-tubulin (benA) gene is a promising target for the identification of Aspergillus species. Assessment of the clinical implementation and performance of benA gene-based Aspergillus polymerase chain reaction (PCR) remains warranted. In this study, we assessed the analytical performance of the [...] Read more.
The β-tubulin (benA) gene is a promising target for the identification of Aspergillus species. Assessment of the clinical implementation and performance of benA gene-based Aspergillus polymerase chain reaction (PCR) remains warranted. In this study, we assessed the analytical performance of the BenA probe PCR in comparison with the Aspergenius kit. We prospectively collected bronchoalveolar lavage (BAL) fluid via diagnostic bronchoscopy from adult patients with hematologic diseases. BenA gene-based multiplex real-time PCR and sequential melting temperature analysis were performed to detect the azole resistance of Aspergillus fumigatus. In total, 76 BAL fluids in 75 patients suspicious of invasive pulmonary aspergillosis (IPA) were collected. Before the application of PCR, the prevalence of proven and probable IPA was 32.9%. However, after implementing the benA gene-based PCR, 15.8% (12 out of 76) of potential IPA cases were reclassified as probable IPA. The analytical performance of the BenA probe PCR in BAL samples was comparable to that of the Aspergenius kit. The diagnostic performance was as follows: sensitivity, 52.0%; specificity, 64.7%; positive predictive value, 41.9%; negative predictive value, 73.3%; positive likelihood ratio, 1.473; and negative likelihood ratio, 0.741. Moreover, benA gene-based Aspergillus PCR discriminated all major sections of Aspergillus, including cryptic species such as Aspergillus tubingensis. Sequential melting temperature analysis successfully detected 2 isolates (15.4%) of A. fumigatus carrying resistant mutations. BenA gene-based Aspergillus PCR with melting temperature analysis enhances diagnostic accuracy and detects not only cryptic species but also resistant mutations of A. fumigatus. It shows promise for clinical applications in the diagnosis of IPA. Full article
(This article belongs to the Special Issue Diagnosis of Invasive Fungal Diseases)
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10 pages, 4728 KiB  
Case Report
Clinical and Radiological Features of Pneumocystis jirovecii Pneumonia in Children: A Case Series
by Erica Ricci, Claudia Bartalucci, Chiara Russo, Marcello Mariani, Carolina Saffioti, Erika Massaccesi, Filomena Pierri, Giacomo Brisca, Andrea Moscatelli, Roberta Caorsi, Bianca Bruzzone, Maria Beatrice Damasio, Anna Marchese, Alessio Mesini and Elio Castagnola
J. Fungi 2024, 10(4), 276; https://0-doi-org.brum.beds.ac.uk/10.3390/jof10040276 - 09 Apr 2024
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Abstract
Background: Pneumocytis jirovecii pneumonia (PJP) has high mortality rates in immunocompromised children, even though routine prophylaxis has decreased in incidence. The aim of this case series is to present the radiological and clinical pathway of PJP in a pediatric population. Description of Cases: [...] Read more.
Background: Pneumocytis jirovecii pneumonia (PJP) has high mortality rates in immunocompromised children, even though routine prophylaxis has decreased in incidence. The aim of this case series is to present the radiological and clinical pathway of PJP in a pediatric population. Description of Cases: All PJP cases in non-HIV/AIDS patients diagnosed at Istituto Giannina Gaslini Pediatric Hospital in Genoa (Italy) from January 2012 until October 2022 were retrospectively evaluated. Nine cases were identified (median age: 8.3 years), and of these, 6/9 underwent prophylaxis with trimethoprim/sulfamethoxazole (TMP/SMX; five once-a-week schedules and one three times-a-week schedule), while 3/9 did not receive this. PJP was diagnosed by real-time PCR for P. jirovecii-DNA in respiratory specimens in 7/9 cases and two consecutive positive detections of β-d-glucan (BDG) in the serum in 2/9 cases. Most patients (6/8) had a CT scan with features suggestive of PJP, while one patient did not undergo a scan. All patients were treated with TMP/SMX after a median time from symptoms onset of 3 days. In 7/9 cases, empirical TMP/SMX treatment was initiated after clinical suspicion and radiological evidence and later confirmed by microbiological data. Clinical improvement with the resolution of respiratory failure and 30-day survival included 100% of the study population. Discussion: Due to the difficulty in obtaining biopsy specimens, PJP diagnosis is usually considered probable in most cases. Moreover, the severity of the clinical presentation often leads physicians to start TMP/SMX treatment empirically. BDG proved to be a useful tool for diagnosis, and CT showed good accuracy in identifying typical patterns. In our center, single-day/week prophylaxis was ineffective in high-risk patients; the three-day/week schedule would, therefore, seem preferable and, in any case, should be started promptly in all patients who have an indication of pneumonia. Full article
(This article belongs to the Special Issue Diagnosis of Invasive Fungal Diseases)
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