Molecular markers: an important tool in the diagnosis, treatment and epidemiology of invasive aspergillosis

Increase in the incidence of invasive aspergillosis has presented a difficult problem for management of patients with this infection due to its high rate of mortality, limited knowledge concerning its diagnosis, and therapeutic practice. Difficulty in management of patients with aspergillosis initiates with detection of the fungus in the specimens of immunosuppressed patients infected with Aspergillus fumigatus. In addition, difficulty exists in terms of the development of resistance to antifungals as a consequence of their indiscriminate use in prophylactic and therapeutic practice and to ignorance concerning the epidemiological data of aspergillosis. With the aim of resolving these problems, molecular markers are currently used with specific and accurate results. However, in Mexico, routine use of molecular markers has not yet been implemented in intrahospital laboratories despite the fact that these molecular markers have been widely reported in the literature. It is necessary for use of these markers to be validated and standardized to ensure that the results obtained in any laboratory would be reliable and comparable. In the present review we present an update on the usefulness of molecular markers in the accurate identification of A. fumigatus, detection of resistance to antifugal triazoles, and epidemiological studies for establishing the necessary measures for prevention and control of aspergillosis.