國家衛生研究院 NHRI:Item 3990099045/9142
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    题名: Diagnostic role of an oligonucleotide array in a heart transplantation patient with invasive pulmonary aspergillosis
    作者: Li, MC;Chang, TC;Wu, CJ;Luo, CY;Ko, WC
    贡献者: Division of Infectious Diseases
    摘要: Dear Editor,Invasive mycoses remains an important issue for immunocompromised patients based on recent studies.1 and 2 Early diagnosis of invasive aspergillosis is especially essential to a favorable outcome because the mortality rate is as high as 70%.3 For rapid identification of molds, an oligonucleotide array was developed based on the internal transcribed spacer-1 (ITS-1) and ITS-2 sequences of the rRNA genes.4 The array can identify 64 species of fungi with a high sensitivity (98.3%) and specificity (98.1%). However, its usefulness for direct detection of fungi in clinical specimens has not been approved. Therefore, we presented a patient as clinical experience of the application of oligonucleotide array for rapid diagnosis of invasive pulmonary aspergillosis. The study was approved by the Institutional Review Board of National Cheng Kung University Hospital, Tainan, Taiwan (Number: B-ER-101-071). A 44-year-old man with dilated cardiomyopathy was hospitalized due to congestive heart failure. He received heart transplantation, and the hospital course was complicated by candidemia, Enterococcus bacteremia, Enterobacter cloacae bacteremia, acute kidney injury requiring renal replacement therapy, bleeding at left pararenal space, and hemoperitoneum intervened by transcatheter arterial embolization, and ventilator-associated pneumonia. Follow-up computed tomography (CT) revealed left pararenal and perisplenic hematoma and right lung consolidation. Sputum culture isolated Stenotrophomonas maltophilia and a mold. Chest CT 13 days after the first CT, demonstrated a cavitary lesion over the right lower lung ( Figure 1A). The index of the optical density of Aspergillus galactomannan determined by a kit (Platelia Aspergillus EIA; Bio-Rad, Marnes-la-Coquette, France) in serum and bronchoalveolar lavage fluid was 2.1 and 7.17, respectively. Voriconazole was prescribed and gradual improvement was shown on CT galactomannan ( Figure 1B). The patient was discharged without sequel. Using the array, Aspergillus fumigatus and Aspergillus terreus were detected in the sputum ( Figure 1C). Sputum fungal culture reported the isolates of Aspergillus species after 26 working days. The colony was identified as A. terreus by the oligonucleotide array ( Figure 1D) and ITS sequencing. 4
    日期: 2016-10
    關聯: Journal of Microbiology, Immunology and Infection. 2016 Oct;49(5):817-818.
    Link to: http://dx.doi.org/10.1016/j.jmii.2015.05.025
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=1684-1182&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000388267800028
    Cited Times(Scopus): http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=84937155048
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