Abstract

To determine the usefulness of a polymerase chain reaction (PCR) and RNA hybridization method for the diagnosis of invasive candidiasis and to compare its sensitivity with blood cultures. Blood cultures and a blood sample for PCR were taken from patients with suspected invasive candidiasis. A 105 base pair conserved segment within the rDNA of Candida species was amplified. The amplicon was detected by hybridization and gel electrophoresis. Intensive care units of two tertiary care hospitals. One hundred and eighteen patients 16 years of age or older with four more risk factors for invasive candidiasis were enrolled. Present or recent past treatment with broad spectrum antibiotics, cancer chemotherapy, immunosuppressive drugs, granulocytopenia or granulocytosis, intravascular catheterization, tracheal intubation, recent abdominal surgery and parenteral nutrition were considered risk factors. Forty-three patients had invasive candidiasis. PCR detected infections in 28 and 26 patients (sensitivity 65.1% and 60.4%) by hybridization and gel electrophoresis, respectively. The sensitivity of blood cultures was 58.1%. Of 25 patients with positive blood cultures, 17 were positive by PCR with the hybridization method. Eleven patients with invasive candidiasis had negative blood cultures but were positive by PCR. PCR, especially with a hybridization detection method, is more sensitive than blood culture for invasive candidiasis and may facilitate the diagnosis of nonfungemic disease.

Highlights

  • We describe a polymerase chain reaction (PCR)-based method with an enzyme immunoassay (EIA) for the detection of the amplified product that appears to be suitable for this purpose

  • Eleven of these patients had more than four risk factors for invasive candidiasis, had negative bacterial cultures from significant sites and had received multiple antibiotics without a response

  • Fungi accounted for about 8% of all nosocomial infections between 1986 and 1989, and 80% of these were caused by Candida species [14]

Read more

Summary

Introduction

Invasive candidiasis was defined as a positive culture for Candida species in blood, deep tissue or normally sterile body fluids excluding urine. A positive blood culture for Candida species and/or the growth of a yeast from a deep tissue or normally sterile body fluid, excluding urine, was defined as invasive candidiasis. Specimens for blood cultures, fungal cultures and PCR were collected when invasive candidiasis was suspected. Blood for cultures and PCR were not always collected simultaneously in the study patients.

Results
Conclusion
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call