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Diagnosing Fungal Keratitis and Simultaneously Identifying Fusarium and Aspergillus Keratitis with a Dot
Ming-Tse Kuo1,2, Shiuh-Liang Hsu3, Huey-Ling You4
1Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Kaohsiung City 83301, Taiwan.
Abstract:
Fungal keratitis (FK) is one of the most common microbial keratitis, which often leads to poor prognosis as a result of delayed diagnosis. Several studies implied that early differentiation of the two major FK, Fusarium and Aspergillus keratitis, could be helpful in selecting effective anti-fungal regimens. Therefore, a novel dot hybridization array (DHA) was developed to diagnose FK and differentiate Fusarium and Aspergillus keratitis in this study. One hundred forty-six corneal scrapes obtained from one hundred forty-six subjects impressed with clinically suspected FK were used to evaluate the performance of the DHA. Among these patients, 107 (73.3%) patients had actual FK confirmed by culture and DNA sequencing. We found that the DHA had 93.5% sensitivity and 97.4% specificity in diagnosing FK. In addition, this array had 93.2% sensitivity and 93.8% specificity in diagnosing Fusarium keratitis, as well as 83.3% sensitivity and 100% specificity in diagnosing Aspergillus keratitis. Furthermore, it had 83.9% sensitivity and 100% specificity in identifying Fusarium solani keratitis. Thus, this newly developed DHA will be beneficial to earlier diagnosis, more precise treatment, and improve prognosis of FK, by minimizing medical refractory events and surgical needs.
Insights
A new dot hybridization array (DHA) accurately diagnoses fungal keratitis (FK) and differentiates Fusarium and Aspergillus species. This diagnostic tool aids in earlier treatment and improves patient outcomes for FK.
Area of Science:
- Ophthalmology
- Mycology
- Molecular Diagnostics
Background:
- Fungal keratitis (FK) is a significant cause of microbial keratitis with poor prognosis due to delayed diagnosis.
- Early differentiation between Fusarium and Aspergillus keratitis is crucial for effective antifungal treatment selection.
Purpose of the Study:
- To develop and evaluate a novel dot hybridization array (DHA) for diagnosing fungal keratitis.
- To differentiate between Fusarium and Aspergillus species causing keratitis using the developed DHA.
Main Methods:
- A dot hybridization array (DHA) was developed for diagnosing fungal keratitis.
- The DHA performance was evaluated using 146 corneal scrape samples from patients with suspected FK.
- Results were confirmed by culture and DNA sequencing.
Main Results:
- The DHA demonstrated 93.5% sensitivity and 97.4% specificity for diagnosing FK.
- It achieved 93.2% sensitivity and 93.8% specificity for Fusarium keratitis.
- The DHA showed 83.3% sensitivity and 100% specificity for Aspergillus keratitis, and 83.9% sensitivity and 100% specificity for Fusarium solani keratitis.
Conclusions:
- The novel DHA is a valuable tool for the early and accurate diagnosis of fungal keratitis.
- This diagnostic advancement can lead to more precise treatment strategies, improved patient prognosis, and reduced need for surgical intervention in FK cases.
