Related Experiment Video

Updated: Jun 14, 2026

Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
08:01

Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology

Published on: March 22, 2012

27.9K

Concordance of Noninvasive Plasma Cell-free DNA With Invasive Diagnostics for Diagnosis of Invasive Fungal Disease

Anthony Lieu1,2,3, Alex N Zimmet1, Joseph Pozdol4

  • 1Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|January 17, 2025
PubMed
Abstract

Insights

Noninvasive mold plasma cell-free DNA (cfDNA) polymerase chain reaction (PCR) testing shows high accuracy for diagnosing invasive mold disease (IMD). This suggests that invasive specimen collection can be reduced in immunocompromised patients.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Molecular Diagnostics

Background:

  • Invasive mold disease (IMD) diagnosis in immunocompromised patients often relies on invasive procedures.
  • Mold plasma cell-free DNA (cfDNA) polymerase chain reaction (PCR) offers a promising noninvasive alternative for early IMD detection.
  • The clinical utility of invasive specimen collection after plasma cfDNA PCR testing remains uncertain.

Purpose of the Study:

  • To evaluate the concordance between mold plasma cfDNA PCR results and conventional fungal diagnostic tests from invasive specimens.
  • To determine if invasive procedures can be safely reduced following noninvasive cfDNA PCR testing.

Main Methods:

  • Retrospective cohort study of 506 patients with mold plasma cfDNA PCR performed around the time of invasive specimen collection.
  • Invasive procedures included tissue biopsy and bronchoscopy.
  • Concordance was assessed between mold plasma cfDNA PCR and fungal tests on tissue/bronchoalveolar lavage fluid, adjudicated by EORTC/MSC guidelines.

Main Results:

  • Overall concordance between mold plasma cfDNA PCR and invasive tests was 88.5% (448/506).
  • In proven IMD cases, 64.7% (11/17) of negative mold plasma cfDNA PCR results were observed in patients with fungal sinusitis or limb infections.
  • Nonhematologic malignancy and nonneutropenic status were linked to negative mold plasma cfDNA PCR in proven/probable IMD.

Conclusions:

  • Noninvasive mold plasma cfDNA PCR demonstrates high concordance with results from invasive fungal diagnostic tests.
  • These findings support curtailing high-risk invasive specimen collection in immunocompromised patients suspected of IMD.
Keywords:
Aspergillus PCRMucorales PCRcell-free DNAmold PCRnon-invasive testing

More Related Videos

Detection and Monitoring of Tumor Associated Circulating DNA in Patient Biofluids06:53

Detection and Monitoring of Tumor Associated Circulating DNA in Patient Biofluids

Published on: June 8, 2019

8.6K
Detection of Cell-Free DNA in Blood Plasma Samples of Cancer Patients08:25

Detection of Cell-Free DNA in Blood Plasma Samples of Cancer Patients

Published on: September 9, 2020

10.9K

Related Concept Videos

Differential Staining Technique01:26

Differential Staining Technique

Differential staining is an essential microbiological technique that exploits variations in cell wall structures to classify and identify microorganisms. It facilitates the distinction of bacteria, aiding in diagnostic and research applications. Two of the most widely used differential staining methods are Gram staining and acid-fast staining, both of which rely on the chemical and structural differences in bacterial cell walls.Gram Staining TechniqueGram staining differentiates bacteria by...
Methods of Classification and Identification01:28

Methods of Classification and Identification

Bacterial identification relies on a diverse array of techniques to classify and understand microorganisms, each tailored to uncover specific characteristics. Traditional morphological approaches, while still valuable, are limited for closely related or structurally simple organisms. Modern methods integrate biochemical, serological, genetic, and advanced molecular tools to achieve greater accuracy.Morphological and Biochemical TechniquesMorphological characteristics, such as cell shape and...
Modern Molecular Taxonomy01:29

Modern Molecular Taxonomy

Advancements in molecular biology have revolutionized the identification and characterization of bacteria, with multiple methods leveraging DNA sequencing for enhanced precision. As sequencing technologies improve and costs decline, these approaches are increasingly used in clinical, environmental, and evolutionary studies.Multilocus Sequence Typing (MLST) examines several housekeeping genes, essential chromosomal genes encoding cellular functions, to distinguish strains. Approximately...
Rapid Identification of Pathogens01:25

Rapid Identification of Pathogens

MALDI-TOF MS has transformed clinical microbiology by offering a rapid and reliable method for pathogen identification. The traditional approach to microbial identification typically involves time-consuming culture techniques and biochemical tests, which can delay the initiation of appropriate antimicrobial therapy. MALDI-TOF MS avoids these delays by using characteristic ribosomal protein mass patterns of microbial cells, enabling accurate species-level identification within minutes.Principle...
Automated Microbial Diagnostics01:24

Automated Microbial Diagnostics

Automated diagnostic analyzers have transformed clinical microbiology by providing rapid and reliable methods for pathogen identification and antibiotic susceptibility testing. Among these systems, the Vitek 2 is widely used because it automates the traditionally labor-intensive processes of microbial identification (ID) and antibiotic susceptibility testing (AST), delivering standardized and timely results that are essential for effective patient care.Microbial Identification with ID CardsThe...