Molecular genetics and the diagnostic mycology laboratory

The laboratory diagnoses or confirmation of fungal diseases are extremely important considerations in the proper and efficient management of patients experiencing these infections. When an infectious process is suspected, suitable material must be collected and submitted to the pathologist for microscopic examination and to the diagnostic laboratory for culture. The practice of modern medicine dictates that the turn-around time be reduced to a minimum so that specific therapy can be rapidly instituted. Unfortunately, the classical procedures used in processing specimens for isolation and identification of fungi implicated in these diseases are technically time consuming and on occasion labor-intensive. More importantly, fungi are slow growing and cultures are frequently held for 3 to 4 weeks before they are discarded as negative. With the exception of coccidioidomycosis, most attempts to develop serological tests for rapid diagnosis of fungal infections have been hampered by poor specificity caused by immunologic cross reactivity. To some extent, such problems can be circumvented by application of molecular biological techniques to these problems. For example, procedures have been developed that allow efficient screening of DNA expression libraries to identify useful recombinant antigens and production of selected antigens in quantity. This is potentially a practical approach using molecular biological techniques for development of sensitive, specific and practical reagents useful in the serological diagnosis of fungal infections. In addition, nucleic acid hybridization techniques based on the ability of complementary nucleic acid strands to specifically align and associate to form stable double-stranded complexes have been put to use to develop confirmation tests for a variety of important fungal isolates.(ABSTRACT TRUNCATED AT 250 WORDS)