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Assessment of a real-time PCR method to detect human non-cryptococcal fungal meningitis
Parisa Badiee1, Abdolvahab Alborzi
1Prof. Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Badieep@yahoo.com
Background:
The signs and symptoms associated with fungal meningitis are similar to those seen with more common bacterial infections. In this study, we investigate whether Aspergillus or Candida DNA can be detected in cerebrospinal fluid (CSF) samples from patients suspected of fungal meningitis using real-time PCR assay.
Methods:
From April 2007 to November 2009, we evaluated CSF samples and sera from patients with risk factors for cerebral fungal meningitis in Nemazi Hospital, Shiraz University of Medical Sciences, Iran, by real-time PCR assay and routine mycological studies (direct microscopy examination and culture). Two CSF and two serum samples from each patient were examined.
Results:
CSF and serum samples from 38 patients (total: 152) suspected of fungal meningitis were examined. India ink staining and KOH smear were negative for all patients. C. albicans was isolated from two CSF samples. There were ten patients with positive real-time PCR results in their CSF samples: three patients had C. albicans, one with C. glabrata, four with Aspergillus species and two with both C. albicans and Aspergillus species DNA. Four patients had positive serum results for Aspergillus or Candida infections.
Conclusion:
Considering the findings, it seems that molecular examination can help in the diagnosis of fungal meningitis in patients with clinical and radiological presentations. Further studies should be conducted in other regions and settings to confirm these findings.
Insights
Real-time PCR detected Aspergillus or Candida DNA in cerebrospinal fluid (CSF) of patients with suspected fungal meningitis. Molecular methods offer a valuable diagnostic tool when clinical signs mimic bacterial infections.
Area of Science:
- Medical Mycology
- Molecular Diagnostics
- Infectious Diseases
Background:
- Fungal meningitis shares symptoms with bacterial meningitis, complicating diagnosis.
- Early and accurate diagnosis is crucial for effective treatment of fungal meningitis.
Purpose of the Study:
- To investigate the utility of real-time PCR for detecting Aspergillus and Candida DNA in cerebrospinal fluid (CSF).
- To assess the efficacy of molecular methods in diagnosing fungal meningitis.
Main Methods:
- Real-time PCR assay performed on CSF and serum samples from 38 patients suspected of fungal meningitis.
- Comparison with routine mycological studies including direct microscopy and culture.
- Samples collected between April 2007 and November 2009.
Main Results:
- Real-time PCR detected fungal DNA in CSF of 10 out of 38 patients.
- Specific findings included DNA from Candida albicans, Candida glabrata, and Aspergillus species.
- Routine mycological studies showed limited positive results, highlighting the sensitivity of PCR.
Conclusions:
- Molecular examination, specifically real-time PCR, aids in diagnosing fungal meningitis.
- Findings suggest PCR is a valuable tool for patients with suggestive clinical and radiological presentations.
- Further multi-regional studies are recommended to validate these diagnostic capabilities.
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