Nahid Gholinejad-Ghadi1, Tahereh Shokohi2,3, Zahra Seifi1, Seyed Reza Aghili2,3, Emmanuel Roilides4, Mehdi Nikkhah5, Rostam Pormosa5, Hossein Karami6, Laleh Vahedi Larjani7, Maryam Ghasemi7, Iman Haghani2. 1. Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. 2. Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. 3. Invasive Fungi Research Centre (IFRC), Mazandaran University of Medical Sciences, Sari, Iran. 4. Infectious Diseases Section, 3rd Department of Pediatrics, Faculty of Medicine, Aristotle University School of Health Sciences, Thessaloniki, Greece. 5. Department of Otolaryngology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. 6. Department of Pediatrics, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran. 7. Department of Pathology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Abstract
BACKGROUND: Accurate diagnosis of mucormycosis, a life-threatening fungal infection, remains a challenge for physicians. OBJECTIVES: To identify the causative Mucorales in fresh clinical samples and formalin-fixed paraffin-embedded (FFPE) samples of patients with proven mucormycosis by molecular method. PATIENTS/ METHODS: Fresh clinical samples of patients with proven mucormycosis according to the EORTC/MSG criteria admitted between 2015 and 2017 and histopathologically proven FFPE archives collected during 2004-2007 and 2015-2017 from Mazandaran University-affiliated hospitals of northern Iran were included. Seminested PCR targeting the 18S rDNA of Mucorales and ITS region was performed, and PCR products were then sequenced. RESULTS: While culture was positive only in 5 of 9 (56%) of fresh specimen cases, PCR was positive in all 9 (100%) histologically proven mucormycosis. Ten of 18 (56%) FFPE samples were PCR-positive. Overall, Mucorales PCR was positive in 19 of 27 (70%) samples. Mucorales species were Rhizopus arrhizus in 16 (84%) cases, R. arrhizus/Amylomyces rouxii in 2 (10.5%) cases and Rhizopus stolonifer in one case (5.5%). Among 27 mucormycosis cases, 25 (93%) cases were rhinocerebral, and 2 (7%) cases were disseminated. Diabetes mellitus (74%) and neutropaenia (63%) were the main risk factors. CONCLUSIONS: Seminested PCR targeting 18S rDNA region of Mucorales is useful for identification of the causative agents of mucormycosis.
BACKGROUND: Accurate diagnosis of mucormycosis, a life-threatening fungal infection, remains a challenge for physicians. OBJECTIVES: To identify the causative Mucorales in fresh clinical samples and formalin-fixed paraffin-embedded (FFPE) samples of patients with proven mucormycosis by molecular method. PATIENTS/ METHODS: Fresh clinical samples of patients with proven mucormycosis according to the EORTC/MSG criteria admitted between 2015 and 2017 and histopathologically proven FFPE archives collected during 2004-2007 and 2015-2017 from Mazandaran University-affiliated hospitals of northern Iran were included. Seminested PCR targeting the 18S rDNA of Mucorales and ITS region was performed, and PCR products were then sequenced. RESULTS: While culture was positive only in 5 of 9 (56%) of fresh specimen cases, PCR was positive in all 9 (100%) histologically proven mucormycosis. Ten of 18 (56%) FFPE samples were PCR-positive. Overall, Mucorales PCR was positive in 19 of 27 (70%) samples. Mucorales species were Rhizopus arrhizus in 16 (84%) cases, R. arrhizus/Amylomyces rouxii in 2 (10.5%) cases and Rhizopus stolonifer in one case (5.5%). Among 27 mucormycosis cases, 25 (93%) cases were rhinocerebral, and 2 (7%) cases were disseminated. Diabetes mellitus (74%) and neutropaenia (63%) were the main risk factors. CONCLUSIONS: Seminested PCR targeting 18S rDNA region of Mucorales is useful for identification of the causative agents of mucormycosis.
Authors: Shawn R Lockhart; Ralf Bialek; Christopher C Kibbler; Manuel Cuenca-Estrella; Henrik E Jensen; Dimitrios P Kontoyiannis Journal: Clin Infect Dis Date: 2021-03-12 Impact factor: 9.079
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