Evaluation of mass spectrometry detection of pan-fungal serum disaccharide (MS-DS) for the diagnosis of invasive fungal infections: results from a collaborative study involving six European clinical centres.
Fiche publication
Date publication
février 2019
Journal
Journal of clinical microbiology
Auteurs
Membres identifiés du Cancéropôle Est :
Pr HERBRECHT Raoul
Tous les auteurs :
Cornu M, Sendid B, Mery A, François N, Malgorzata M, Letscher-Bru V, De Carolis E, Damonti L, Titecat M, Bochud PY, Alanio A, Sanguinetti M, Viscoli C, Herbrecht R, Guerardel Y, Poulain D
Lien Pubmed
Résumé
A mass spectrometry (MS) method that detects a serum disaccharide (MS-DS) was recently described for the diagnosis of invasive fungal infections (IFI). We carried out a European collaborative study to evaluate this assay. Patients with IFI were selected according to the availability of sera obtained around the time that IFI was documented: invasive candidiasis (IC; n=26 patients), invasive aspergillosis (IA; n=19), mucormycosis (MM; n=23). Control sera originated from 20 neutropenic patients and 20 patients with bacteraemia. MS-DS was carried out blind to IFI diagnosis. Diagnosis of IC and IA was confirmed by detection of (1,3)-β-D-glucan (BDG), mannan (Man) and galactomannan (GM), respectively. MM was detected by q-PCR. All tests discriminated IC sera from controls with bacteraemia (≤0.0009). MS-DS sensitivity and specificity were 51% and 87%, respectively. MS-DS complemented the high specificity of Man monitoring. All tests discriminated IA sera from neutropenic controls (≤0.0009). MS-DS sensitivity and specificity were 64% and 90%, respectively. Only 13/36 MM sera were concordant by MS-DS and q-PCR (six positive and seven negative); 14 were positive by MS-DS alone. q-PCR and MS-DS made a similar contribution to the diagnosis of MM. In patients undergoing long-term monitoring, persistent MS-DS circulation was observed whereas DNA was only detected for a short period after initiation of treatment. MS-DS has an important role to play in the early diagnosis of IFI. Its pan fungal nature and complementarity with other tests may justify its use in the management of IFI.
Référence
J. Clin. Microbiol.. 2019 Feb 20;: