Tissue-Based Molecular Diagnostics Evaluation in Combat-Related Invasive Fungal Wound Infections
Abstract
Trauma-related invasive fungal wound infections (IFIs) are associated with significant morbidity and mortality and early identification andtreatment are critical. We assessed a panfungal PCR-based sequencing assay for rapid identification of filamentous fungi in formalin-fixedparaffin-embedded (FFPE) specimens obtained from combat casualties injured in Afghanistan. The internal transcribed spacer 2 (ITS2) region ofthe fungal ribosomal repeat was amplified and sequenced. The PCR results were compared with findings from histopathology and/or culture. Weincluded 64 case subjects (contributing 95 sites) and 102 controls (contributing 118 sites). Compared to histopathology, panfungal PCR wasspecific (99 ), but not as sensitive (63 ); however, sensitivity improved to 83 in specimens from sites with angioinvasion. Panfungal PCRidentified fungi of the order Mucorales in 33 of 44 sites with angioinvasion (75 ), whereas fungal culture was positive in 20 of 44 sites (45 ).Saksenaea spp. were the dominant fungi identified by PCR in specimens from angioinvasion sites (57 ). Panfungal PCR is specific, albeit withlower sensitivity, and performs better at identifying fungi of the order Mucorales than culture.
Document Details
- Document Type
- Technical Report
- Publication Date
- Sep 12, 2018
- Accession Number
- AD1118944
Entities
People
- Anuradha Ganesan
- David R. Tribble
Organizations
- Uniformed Services University of the Health Sciences