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

被引:5
作者
Guenter, Sara [1 ]
Gorkiewicz, Gregor [2 ,3 ]
Halwachs, Bettina [2 ,3 ]
Kashofer, Karl [2 ]
Thueringer, Andrea [2 ]
Wurm, Phillip [2 ,3 ]
Zollner-Schwetz, Ines [1 ]
Valentin, Thomas [1 ]
Prattes, Juergen [1 ,3 ]
Wunsch, Stefanie [1 ]
Ullrich, Elisabeth [1 ,4 ]
Zurl, Christoph [1 ,3 ,5 ]
Hoenigl, Martin [1 ,6 ]
Krause, Robert [1 ,3 ]
机构
[1] Med Univ Graz, Dept Internal Med, Sect Infect Dis & Trop Med, A-8010 Graz, Austria
[2] Med Univ Graz, Diagnost & Res Inst Pathol, A-8010 Graz, Austria
[3] BioTechMed Graz, A-8010 Graz, Austria
[4] Med Univ Graz, Inst Hyg Microbiol & Environm Med, A-8010 Graz, Austria
[5] Med Univ Graz, Dept Paediat & Adolescent Med, Div Gen Paediat, A-8010 Graz, Austria
[6] Univ Calif San Diego, Dept Med, Div Infect Dis & Global Publ Hlth, San Diego, CA 92093 USA
关键词
invasive fungal infections; ITS-sequencing; antifungal therapy; PULMONARY ASPERGILLOSIS; DIAGNOSIS; CANDIDEMIA; DISEASE; TESTS; BLOOD; SERUM;
D O I
10.3390/jof6020043
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
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-beta-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.
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页数:8
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