PCR with electrospray ionization-mass spectrometry on bronchoalveolar lavage for detection of invasive mold infections in hematological patients
Invasive mold infections are life-threatening complications in patients with hematological malignancies. Conventional microbiological methods for diagnosing invasive pulmonary mold infections have low sensitivity, and molecular methods are being developed. Detection of molds using PCR with a narrow...
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| Veröffentlicht in: | PloS one 2019-02, Vol.14 (2), p.e0212812-e0212812 |
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| description | Invasive mold infections are life-threatening complications in patients with hematological malignancies. Conventional microbiological methods for diagnosing invasive pulmonary mold infections have low sensitivity, and molecular methods are being developed. Detection of molds using PCR with a narrow spectrum has been reported, but data with broad-spectrum PCR are lacking. In this study, the diagnostic performance and utility of a broad-spectrum PCR (broad-spectrum PCR with subsequent electrospray ionization-mass spectrometry, PCR/ESI-MS) for detection of molds in bronchoalveolar lavage (BAL) in 27 hematological patients with a new pulmonary infiltrate was analyzed. Using the revised EORTC/MSG criteria, PCR/ESI-MS was the only positive microbiological test in patients with proven invasive mold infection (n = 2) and correctly identified all cases of probable invasive pulmonary aspergillosis (n = 5). In patients with a possible invasive mold infection (n = 5), PCR/ESI-MS was positive in three patients. Mucorales was identified with PCR/ESI-MS in four patients that were all culture negative. The PCR/ESI-MS results had a clinical impact on antifungal therapy in 12 (44%) of the patients: modification of treatment in 6 (22%) patients and discontinuation in 6 (22%) patients. This study provides proof of concept that routine use of a broad-spectrum PCR for molds in bronchoalveolar lavage in immunocompromised patients is sensitive, fast, and has an impact on clinical decision-making. |
| doi_str_mv | 10.1371/journal.pone.0212812 |
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Conventional microbiological methods for diagnosing invasive pulmonary mold infections have low sensitivity, and molecular methods are being developed. Detection of molds using PCR with a narrow spectrum has been reported, but data with broad-spectrum PCR are lacking. In this study, the diagnostic performance and utility of a broad-spectrum PCR (broad-spectrum PCR with subsequent electrospray ionization-mass spectrometry, PCR/ESI-MS) for detection of molds in bronchoalveolar lavage (BAL) in 27 hematological patients with a new pulmonary infiltrate was analyzed. Using the revised EORTC/MSG criteria, PCR/ESI-MS was the only positive microbiological test in patients with proven invasive mold infection (n = 2) and correctly identified all cases of probable invasive pulmonary aspergillosis (n = 5). In patients with a possible invasive mold infection (n = 5), PCR/ESI-MS was positive in three patients. Mucorales was identified with PCR/ESI-MS in four patients that were all culture negative. The PCR/ESI-MS results had a clinical impact on antifungal therapy in 12 (44%) of the patients: modification of treatment in 6 (22%) patients and discontinuation in 6 (22%) patients. This study provides proof of concept that routine use of a broad-spectrum PCR for molds in bronchoalveolar lavage in immunocompromised patients is sensitive, fast, and has an impact on clinical decision-making.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0212812</identifier><identifier>PMID: 30794675</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Aged ; Alveoli ; Analysis ; Antifungal agents ; Aspergillosis ; Biology and Life Sciences ; Bronchoalveolar lavage ; Bronchoalveolar Lavage Fluid - microbiology ; Bronchus ; Clinical decision making ; Complications ; Complications and side effects ; Decision making ; Deoxyribonucleic acid ; Diagnosis ; Diagnostic systems ; Diagnostic tests ; DNA ; Electrospraying ; Enzymes ; Female ; Fungal infections ; Fungicides ; Health aspects ; Hematologic diseases ; Hematologic Neoplasms - microbiology ; Hematologic research ; Hematology ; Hospitals ; Humans ; Immunocompromised host ; Immunocompromised hosts ; Infection ; Infections ; Infectious diseases ; Integrated software ; Ionization ; Laboratories ; Male ; Mass spectrometry ; Mass spectroscopy ; Medical diagnosis ; Medical research ; Medicine ; Medicine and Health Sciences ; Methods ; Microbiology ; Microscopy ; Middle Aged ; Mold ; Molds (Fungi) ; Mucorales ; Mucormycosis - diagnosis ; Mucormycosis - microbiology ; Mycoses ; Patients ; Polymerase Chain Reaction ; Posaconazole ; Pulmonary aspergillosis ; Pulmonary Aspergillosis - diagnosis ; Pulmonary Aspergillosis - microbiology ; Research and Analysis Methods ; Retrospective Studies ; Scientific imaging ; Spectrometry, Mass, Electrospray Ionization ; Spectroscopy ; Systematic review</subject><ispartof>PloS one, 2019-02, Vol.14 (2), p.e0212812-e0212812</ispartof><rights>COPYRIGHT 2019 Public Library of Science</rights><rights>2019 Krifors et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2019 Krifors et al 2019 Krifors et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c730t-d198310bf931e79034c4fa9db83c9437ff662f094dcc450b32690d3644bcc6c73</citedby><cites>FETCH-LOGICAL-c730t-d198310bf931e79034c4fa9db83c9437ff662f094dcc450b32690d3644bcc6c73</cites><orcidid>0000-0003-1230-0492</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6386253/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6386253/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,550,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30794675$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:140400600$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Krifors, Anders</creatorcontrib><creatorcontrib>Özenci, Volkan</creatorcontrib><creatorcontrib>Ullberg, Måns</creatorcontrib><creatorcontrib>Ackefors, Malin</creatorcontrib><creatorcontrib>Jädersten, Martin</creatorcontrib><creatorcontrib>Strålin, Kristoffer</creatorcontrib><creatorcontrib>Blennow, Ola</creatorcontrib><title>PCR with electrospray ionization-mass spectrometry on bronchoalveolar lavage for detection of invasive mold infections in hematological patients</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Invasive mold infections are life-threatening complications in patients with hematological malignancies. Conventional microbiological methods for diagnosing invasive pulmonary mold infections have low sensitivity, and molecular methods are being developed. Detection of molds using PCR with a narrow spectrum has been reported, but data with broad-spectrum PCR are lacking. In this study, the diagnostic performance and utility of a broad-spectrum PCR (broad-spectrum PCR with subsequent electrospray ionization-mass spectrometry, PCR/ESI-MS) for detection of molds in bronchoalveolar lavage (BAL) in 27 hematological patients with a new pulmonary infiltrate was analyzed. Using the revised EORTC/MSG criteria, PCR/ESI-MS was the only positive microbiological test in patients with proven invasive mold infection (n = 2) and correctly identified all cases of probable invasive pulmonary aspergillosis (n = 5). In patients with a possible invasive mold infection (n = 5), PCR/ESI-MS was positive in three patients. Mucorales was identified with PCR/ESI-MS in four patients that were all culture negative. The PCR/ESI-MS results had a clinical impact on antifungal therapy in 12 (44%) of the patients: modification of treatment in 6 (22%) patients and discontinuation in 6 (22%) patients. This study provides proof of concept that routine use of a broad-spectrum PCR for molds in bronchoalveolar lavage in immunocompromised patients is sensitive, fast, and has an impact on clinical decision-making.</description><subject>Adult</subject><subject>Aged</subject><subject>Alveoli</subject><subject>Analysis</subject><subject>Antifungal agents</subject><subject>Aspergillosis</subject><subject>Biology and Life Sciences</subject><subject>Bronchoalveolar lavage</subject><subject>Bronchoalveolar Lavage Fluid - microbiology</subject><subject>Bronchus</subject><subject>Clinical decision making</subject><subject>Complications</subject><subject>Complications and side effects</subject><subject>Decision making</subject><subject>Deoxyribonucleic acid</subject><subject>Diagnosis</subject><subject>Diagnostic systems</subject><subject>Diagnostic tests</subject><subject>DNA</subject><subject>Electrospraying</subject><subject>Enzymes</subject><subject>Female</subject><subject>Fungal infections</subject><subject>Fungicides</subject><subject>Health aspects</subject><subject>Hematologic diseases</subject><subject>Hematologic Neoplasms - microbiology</subject><subject>Hematologic research</subject><subject>Hematology</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Immunocompromised host</subject><subject>Immunocompromised hosts</subject><subject>Infection</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>Integrated software</subject><subject>Ionization</subject><subject>Laboratories</subject><subject>Male</subject><subject>Mass spectrometry</subject><subject>Mass spectroscopy</subject><subject>Medical diagnosis</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Methods</subject><subject>Microbiology</subject><subject>Microscopy</subject><subject>Middle Aged</subject><subject>Mold</subject><subject>Molds (Fungi)</subject><subject>Mucorales</subject><subject>Mucormycosis - diagnosis</subject><subject>Mucormycosis - microbiology</subject><subject>Mycoses</subject><subject>Patients</subject><subject>Polymerase Chain Reaction</subject><subject>Posaconazole</subject><subject>Pulmonary aspergillosis</subject><subject>Pulmonary Aspergillosis - diagnosis</subject><subject>Pulmonary Aspergillosis - microbiology</subject><subject>Research and Analysis Methods</subject><subject>Retrospective Studies</subject><subject>Scientific imaging</subject><subject>Spectrometry, Mass, Electrospray Ionization</subject><subject>Spectroscopy</subject><subject>Systematic review</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>D8T</sourceid><sourceid>DOA</sourceid><recordid>eNqNk8tu1DAUhiMEoqXwBggsISFYzGDHjp1skKqKS6VKRdy21onjzLg4cbCdKeUpeGQ8M2nVoC5QFnbs7_9tn0uWPSV4Saggby7c6Huwy8H1eolzkpckv5cdkormC55jev_W_CB7FMIFxgUtOX-YHVAsKsZFcZj9-XTyGV2auEbaahW9C4OHK2Rcb35DTMOigxBQGHabnY7-Crke1d71au3AbrSz4JGFDaw0ap1HjY6JTUrkWmT6DQSz0ahztkl_7X4rpCla6w6is25lFFg0pNN0H8Pj7EELNugn03iUfXv_7uvJx8XZ-YfTk-OzhRIUx0VDqpISXLcVJVpUmDLFWqiauqSqYlS0Led5iyvWKMUKXNOcV7ihnLFaKZ48jrLne9_BuiCnYAaZk5JTUvC8SMTpnmgcXMjBmw78lXRg5G7B-ZUEH42yWjaCMZbTHGvgrKAAFRei4C2v8xKzBievxd4rXOphrGdu09KPNNOSlUSwKvFvp9uNdacblSLjwc5k853erOXKbSRPGU53TwavJgPvfo46RNmZoLS10Gs37t5ZFIUQlCf0xT_o3dGYqBWkB6dMunSu2prK40IUFGNGt_de3kGlr9GdUalSW5PWZ4LXM0Fiov4VVzCGIE-_fP5_9vz7nH15i11rsHEdnB131TcH2R5UqfaD1-1NkAmW20a7jobcNpqcGi3Jnt1O0I3ourPoX2bQJfw</recordid><startdate>20190222</startdate><enddate>20190222</enddate><creator>Krifors, Anders</creator><creator>Özenci, Volkan</creator><creator>Ullberg, Måns</creator><creator>Ackefors, Malin</creator><creator>Jädersten, Martin</creator><creator>Strålin, Kristoffer</creator><creator>Blennow, Ola</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>ZZAVC</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-1230-0492</orcidid></search><sort><creationdate>20190222</creationdate><title>PCR with electrospray ionization-mass spectrometry on bronchoalveolar lavage for detection of invasive mold infections in hematological patients</title><author>Krifors, Anders ; Özenci, Volkan ; Ullberg, Måns ; Ackefors, Malin ; Jädersten, Martin ; Strålin, Kristoffer ; Blennow, Ola</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c730t-d198310bf931e79034c4fa9db83c9437ff662f094dcc450b32690d3644bcc6c73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Alveoli</topic><topic>Analysis</topic><topic>Antifungal agents</topic><topic>Aspergillosis</topic><topic>Biology and Life Sciences</topic><topic>Bronchoalveolar lavage</topic><topic>Bronchoalveolar Lavage Fluid - 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Conventional microbiological methods for diagnosing invasive pulmonary mold infections have low sensitivity, and molecular methods are being developed. Detection of molds using PCR with a narrow spectrum has been reported, but data with broad-spectrum PCR are lacking. In this study, the diagnostic performance and utility of a broad-spectrum PCR (broad-spectrum PCR with subsequent electrospray ionization-mass spectrometry, PCR/ESI-MS) for detection of molds in bronchoalveolar lavage (BAL) in 27 hematological patients with a new pulmonary infiltrate was analyzed. Using the revised EORTC/MSG criteria, PCR/ESI-MS was the only positive microbiological test in patients with proven invasive mold infection (n = 2) and correctly identified all cases of probable invasive pulmonary aspergillosis (n = 5). In patients with a possible invasive mold infection (n = 5), PCR/ESI-MS was positive in three patients. Mucorales was identified with PCR/ESI-MS in four patients that were all culture negative. The PCR/ESI-MS results had a clinical impact on antifungal therapy in 12 (44%) of the patients: modification of treatment in 6 (22%) patients and discontinuation in 6 (22%) patients. This study provides proof of concept that routine use of a broad-spectrum PCR for molds in bronchoalveolar lavage in immunocompromised patients is sensitive, fast, and has an impact on clinical decision-making.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>30794675</pmid><doi>10.1371/journal.pone.0212812</doi><tpages>e0212812</tpages><orcidid>https://orcid.org/0000-0003-1230-0492</orcidid><oa>free_for_read</oa></addata></record> |
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| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2186315625 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; SWEPUB Freely available online; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Adult Aged Alveoli Analysis Antifungal agents Aspergillosis Biology and Life Sciences Bronchoalveolar lavage Bronchoalveolar Lavage Fluid - microbiology Bronchus Clinical decision making Complications Complications and side effects Decision making Deoxyribonucleic acid Diagnosis Diagnostic systems Diagnostic tests DNA Electrospraying Enzymes Female Fungal infections Fungicides Health aspects Hematologic diseases Hematologic Neoplasms - microbiology Hematologic research Hematology Hospitals Humans Immunocompromised host Immunocompromised hosts Infection Infections Infectious diseases Integrated software Ionization Laboratories Male Mass spectrometry Mass spectroscopy Medical diagnosis Medical research Medicine Medicine and Health Sciences Methods Microbiology Microscopy Middle Aged Mold Molds (Fungi) Mucorales Mucormycosis - diagnosis Mucormycosis - microbiology Mycoses Patients Polymerase Chain Reaction Posaconazole Pulmonary aspergillosis Pulmonary Aspergillosis - diagnosis Pulmonary Aspergillosis - microbiology Research and Analysis Methods Retrospective Studies Scientific imaging Spectrometry, Mass, Electrospray Ionization Spectroscopy Systematic review |
| title | PCR with electrospray ionization-mass spectrometry on bronchoalveolar lavage for detection of invasive mold infections in hematological patients |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-09T03%3A09%3A48IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=PCR%20with%20electrospray%20ionization-mass%20spectrometry%20on%20bronchoalveolar%20lavage%20for%20detection%20of%20invasive%20mold%20infections%20in%20hematological%20patients&rft.jtitle=PloS%20one&rft.au=Krifors,%20Anders&rft.date=2019-02-22&rft.volume=14&rft.issue=2&rft.spage=e0212812&rft.epage=e0212812&rft.pages=e0212812-e0212812&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0212812&rft_dat=%3Cgale_plos_%3EA575300439%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2186315625&rft_id=info:pmid/30794675&rft_galeid=A575300439&rft_doaj_id=oai_doaj_org_article_d74442320ea6453aa967756f6b2804d0&rfr_iscdi=true |