Impact of ITS-Based Sequencing on Antifungal Treatment of Patients with Suspected Invasive Fungal Infections.

ITS-sequencing antifungal therapy invasive fungal infections

Journal

Journal of fungi (Basel, Switzerland)
ISSN: 2309-608X
Titre abrégé: J Fungi (Basel)
Pays: Switzerland
ID NLM: 101671827

Informations de publication

Date de publication:
27 Mar 2020
Historique:
received: 08 02 2020
revised: 14 03 2020
accepted: 25 03 2020
entrez: 2 4 2020
pubmed: 2 4 2020
medline: 2 4 2020
Statut: epublish

Résumé

Molecular techniques including the sequencing of fungal-specific DNA targets are increasingly used in the diagnosis of suspected invasive fungal infections. In contrast to established biomarkers like galactomannan or 1-3-β-d-glucan, the clinical impact of these methods remains unknown. We retrospectively investigated the impact of ITS1-sequencing on antifungal treatment strategies in 71 patients (81 samples) with suspected invasive fungal infections. ITS-sequencing either confirmed already ongoing antifungal therapy (19/71 patients, 27%), led to a change in antifungal therapy (11/71, 15%) or supported the decision to withhold antifungal treatment (34/71, 48%) (in seven of 71 patients, ITS-sequencing results were obtained postmortem). ITS-sequencing results led to a change in antifungal therapy in a relevant proportion of patients, while it confirmed therapeutic strategies in the majority. Therefore, ITS-sequencing was a useful adjunct to other fungal diagnostic measures in our cohort.

Identifiants

pubmed: 32230706
pii: jof6020043
doi: 10.3390/jof6020043
pmc: PMC7345167
pii:
doi:

Types de publication

Journal Article

Langues

eng

Déclaration de conflit d'intérêts

The authors declare no conflict of interest.

Références

Med Mycol. 2014 Jul;52(5):455-61
pubmed: 24906361
Nat Methods. 2012 Apr 27;9(5):425-6
pubmed: 22543370
Clin Infect Dis. 2013 May;56(9):1284-92
pubmed: 23315320
J Clin Microbiol. 2016 Jan;54(1):148-52
pubmed: 26560539
Bioinformatics. 2010 Oct 1;26(19):2460-1
pubmed: 20709691
JAMA. 2009 Dec 2;302(21):2323-9
pubmed: 19952319
J Infect. 2012 Dec;65(6):588-91
pubmed: 23078908
J Infect. 2018 Sep;77(3):235-241
pubmed: 29972764
Lancet Infect Dis. 2019 Dec;19(12):e405-e421
pubmed: 31699664
PLoS One. 2016 May 20;11(5):e0155033
pubmed: 27206014
Clin Infect Dis. 2014 Dec 15;59(12):1696-702
pubmed: 25165088
Clin Infect Dis. 2015 Mar 15;60(6):892-9
pubmed: 25586686
Am J Respir Crit Care Med. 2012 Jul 1;186(1):56-64
pubmed: 22517788
Lancet Infect Dis. 2003 Nov;3(11):685-702
pubmed: 14592598
Clin Infect Dis. 2019 Dec 05;:
pubmed: 31802125
Clin Infect Dis. 2006 Jul 1;43(1):25-31
pubmed: 16758414
Med Mycol. 2020 Jul 1;58(5):632-638
pubmed: 31613367
Clin Microbiol Infect. 2018 May;24 Suppl 1:e1-e38
pubmed: 29544767
Virulence. 2017 Apr 3;8(3):334-341
pubmed: 27687858
Am J Respir Crit Care Med. 2014 Oct 15;190(8):922-9
pubmed: 25203869
Med Mycol. 2020 Jul 1;58(5):650-660
pubmed: 31758176
Front Microbiol. 2017 Feb 14;8:180
pubmed: 28261162
Antimicrob Agents Chemother. 2005 Sep;49(9):3640-5
pubmed: 16127033
Nat Rev Microbiol. 2019 Jan;17(2):95-109
pubmed: 30442909
PLoS One. 2011 Mar 09;6(3):e17288
pubmed: 21408061
Genome Biol. 2011 Jun 24;12(6):R60
pubmed: 21702898
Mycoses. 2017 Dec;60(12):818-825
pubmed: 28877383
J Clin Microbiol. 2020 Feb 24;58(3):
pubmed: 31852762
Med Mycol. 2000;38 Suppl 1:147-59
pubmed: 11204140
Front Microbiol. 2018 Sep 19;9:2208
pubmed: 30283425
Nat Methods. 2010 May;7(5):335-6
pubmed: 20383131
Clin Infect Dis. 2008 Jun 15;46(12):1813-21
pubmed: 18462102
J Fungi (Basel). 2017 Oct 18;3(4):
pubmed: 29371573
Sci Rep. 2018 May 3;8(1):6964
pubmed: 29725065

Auteurs

Sara Guenter (S)

Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz 8010, Austria.

Gregor Gorkiewicz (G)

Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz 8010, Austria.
BioTechMed-Graz, Graz 8010, Austria.

Bettina Halwachs (B)

Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz 8010, Austria.
BioTechMed-Graz, Graz 8010, Austria.

Karl Kashofer (K)

Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz 8010, Austria.

Andrea Thueringer (A)

Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz 8010, Austria.

Phillip Wurm (P)

Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz 8010, Austria.
BioTechMed-Graz, Graz 8010, Austria.

Ines Zollner-Schwetz (I)

Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz 8010, Austria.

Thomas Valentin (T)

Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz 8010, Austria.

Juergen Prattes (J)

Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz 8010, Austria.
BioTechMed-Graz, Graz 8010, Austria.

Stefanie Wunsch (S)

Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz 8010, Austria.

Elisabeth Ullrich (E)

Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz 8010, Austria.
Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz 8010, Austria.

Christoph Zurl (C)

Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz 8010, Austria.
BioTechMed-Graz, Graz 8010, Austria.
Division of General Paediatrics, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz 8010, Austria.

Martin Hoenigl (M)

Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz 8010, Austria.
Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, San Diego, CA 92093, USA.

Robert Krause (R)

Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz 8010, Austria.
BioTechMed-Graz, Graz 8010, Austria.

Classifications MeSH