Diagnostic Modalities for Invasive Mould Infections among Hematopoietic Stem Cell Transplant and Solid Organ Recipients: Performance Characteristics and Practical Roles in the Clinic

Ghady Haidar; Bonnie A Falcione; M Hong Nguyen

doi:10.3390/jof1020252

Diagnostic Modalities for Invasive Mould Infections among Hematopoietic Stem Cell Transplant and Solid Organ Recipients: Performance Characteristics and Practical Roles in the Clinic

J Fungi (Basel). 2015 Sep 10;1(2):252-276. doi: 10.3390/jof1020252.

Authors

Ghady Haidar¹, Bonnie A Falcione^{2

3

4}, M Hong Nguyen^{5

6}

Affiliations

¹ Department of Medicine, University of Pittsburgh Medical Center, Scaife Hall, Suite 871, 3550 Terrace Street, Pittsburgh, PA 15261, USA. haidarg@upmc.edu.
² Department of Medicine, University of Pittsburgh Medical Center, Scaife Hall, Suite 871, 3550 Terrace Street, Pittsburgh, PA 15261, USA. FalcioneBA@upmc.edu.
³ Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, 200 Lothrop St. 301, Pittsburgh, PA 15213, USA. FalcioneBA@upmc.edu.
⁴ Department of Medicine, University of Pittsburgh, Scaife Hall, Suite 871, 3550 Terrace Street, Pittsburgh, PA 15261, USA. FalcioneBA@upmc.edu.
⁵ Department of Medicine, University of Pittsburgh Medical Center, Scaife Hall, Suite 871, 3550 Terrace Street, Pittsburgh, PA 15261, USA. MHN5@pitt.edu.
⁶ Department of Medicine, University of Pittsburgh, Scaife Hall, Suite 871, 3550 Terrace Street, Pittsburgh, PA 15261, USA. MHN5@pitt.edu.

Abstract

The morbidity and mortality of hematopoietic stem cell and solid organ transplant patients with invasive fungal infections (IFIs) remain high despite an increase in the number of effective antifungal agents. Early diagnosis leading to timely administration of antifungal therapy has been linked to better outcomes. Unfortunately, the diagnosis of IFIs remains challenging. The current gold standard for diagnosis is a combination of histopathology and culture, for which the sensitivity is <50%. Over the past two decades, a plethora of non-culture-based antigen and molecular assays have been developed and clinically validated. In this article, we will review the performance of the current commercially available non-cultural diagnostics and discuss their practical roles in the clinic.

Keywords: PCR; aspergillosis; diagnostic biomarker; galactomannan; hematological malignancy; hematopoietic stem cell transplant; invasive mould infections; solid organ transplant; β-d-glucan.

Publication types

Review