TY - JOUR
T1 - Evaluation of mass spectrometry-based detection of panfungal serum disaccharide for diagnosis of invasive fungal infections
T2 - Results from a collaborative study involving six European clinical centers
AU - Cornu, Marjorie
AU - Sendid, Boualem
AU - Mery, Alexandre
AU - François, Nadine
AU - Malgorzata, Mikulska
AU - Letscher-Bru, Valérie
AU - De Carolis, Elena
AU - Damonti, Lauro
AU - Titecat, Marie
AU - Bochud, Pierre Yves
AU - Alanio, Alexandre
AU - Sanguinetti, Maurizio
AU - Viscoli, Claudio
AU - Herbrecht, Raoul
AU - Guerardel, Yann
AU - Poulaina, Daniel
PY - 2019/5/1
Y1 - 2019/5/1
N2 - A mass spectrometry (MS) method that detects a serum disaccharide (DS) (MS-DS) was recently described for the diagnosis of invasive fungal infections (IFI). We carried out a European collaborative study to evaluate this assay. Patients with the following IFI were selected according to the availability of sera obtained at about the time that IFI was documented: invasive candidiasis (IC; n 26 patients), invasive aspergillosis (IA; n 19), and mucormycosis (MM; n 23). Control sera originated from 20 neutropenic patients and 20 patients with bacteremia. MS-DS was carried out in blind manner for the diagnosis of IFI. A diagnosis of IC or IA was confirmed by detection of mannan (Man) or galactomannan (GM), respectively, associated with detection of (1,3)-D-glucan (BDG) in both infections. MM was detected by quantitative real-time PCR (qPCR). All tests discriminated sera from patients with IC from sera from control subjects with bacteremia (P 0.0009). For IC, the MS-DS sensitivity and specificity were 51% and 87%, respectively. MS-DS complemented the high specificity of Man monitoring. All tests discriminated sera from IA patients from sera from neutropenic controls (P 0.0009). For IA, MS-DS sensitivity and specificity were 64% and 95%, respectively. Only 13/36 serum samples from patients with MM were concordant by MS-DS and qPCR (6 were positive, and 7 were negative); 14 were positive by MS-DS alone. qPCR and MS-DS made a similar contribution to the diagnosis of MM. In patients undergoing long-term monitoring, the persistent circulation of serum disaccharide was observed, whereas DNA was detected only for a short period after initiation of treatment. MS-DS has an important role to play in the early diagnosis of IFI. Its panfungal nature and complementarity with other tests may justify its use in the management of IFI.
AB - A mass spectrometry (MS) method that detects a serum disaccharide (DS) (MS-DS) was recently described for the diagnosis of invasive fungal infections (IFI). We carried out a European collaborative study to evaluate this assay. Patients with the following IFI were selected according to the availability of sera obtained at about the time that IFI was documented: invasive candidiasis (IC; n 26 patients), invasive aspergillosis (IA; n 19), and mucormycosis (MM; n 23). Control sera originated from 20 neutropenic patients and 20 patients with bacteremia. MS-DS was carried out in blind manner for the diagnosis of IFI. A diagnosis of IC or IA was confirmed by detection of mannan (Man) or galactomannan (GM), respectively, associated with detection of (1,3)-D-glucan (BDG) in both infections. MM was detected by quantitative real-time PCR (qPCR). All tests discriminated sera from patients with IC from sera from control subjects with bacteremia (P 0.0009). For IC, the MS-DS sensitivity and specificity were 51% and 87%, respectively. MS-DS complemented the high specificity of Man monitoring. All tests discriminated sera from IA patients from sera from neutropenic controls (P 0.0009). For IA, MS-DS sensitivity and specificity were 64% and 95%, respectively. Only 13/36 serum samples from patients with MM were concordant by MS-DS and qPCR (6 were positive, and 7 were negative); 14 were positive by MS-DS alone. qPCR and MS-DS made a similar contribution to the diagnosis of MM. In patients undergoing long-term monitoring, the persistent circulation of serum disaccharide was observed, whereas DNA was detected only for a short period after initiation of treatment. MS-DS has an important role to play in the early diagnosis of IFI. Its panfungal nature and complementarity with other tests may justify its use in the management of IFI.
KW - Invasive aspergillosis
KW - Invasive candidiasis
KW - Invasive fungal infection
KW - Mass spectrometry
KW - Mucormycosis
KW - Serological diagnosis
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U2 - 10.1128/JCM.01867-18
DO - 10.1128/JCM.01867-18
M3 - Article
C2 - 30787140
AN - SCOPUS:85065315885
VL - 57
JO - Journal of Clinical Microbiology
JF - Journal of Clinical Microbiology
SN - 0095-1137
IS - 5
M1 - e01867-18
ER -