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在怀疑呼吸道菌感染的癌症患者中进行分子诊断

V Rickerts¹, J Springer², J Gerkrath¹

¹Robert Koch-Institut, Unit 16: Mycotic and Parasitic Agents and Mycobacteria, Berlin, Germany.

Journal of clinical microbiology

|November 26, 2025

概括

针对支气管洗液 (BALF) 中的模具的特定qPCR测定对于在癌症患者中检测侵入性真菌感染最为敏感. 这些测试优于培养和血清分析,有助于诊断和治疗菌肺炎.

科学领域:

医学微生物学医学微生物学
传染性疾病传染性疾病
在瘤学瘤学.

背景情况:

侵入性真菌感染 (IFI),包括阿斯伯吉洛症和粘菌菌病,对癌症患者构成重大风险.
准确检测真菌病原体对于有效的患者管理至关重要,但仍然具有挑战性.

研究的目的:

为了比较不同诊断方法的灵敏度和特异性,以检测成年癌症患者的菌肺炎.
评估支气管洗液 (BALF) 和血清样本在识别Aspergillus和Mucorales感染中的实用性.

主要方法:

一项前性多中心研究,涉及210例癌症患者的IFI发作.
使用培养物,特异性/非特异性qPCR和光在位混合 (FISH) 的真菌检测的比较. 在BALF和血清上.
在BALF和血清样本中对Aspergillus和MucoralesDNA检测的分析.

主要成果:

在BALF中针对Aspergillus和Mucorales的特定qPCR测定表明,与FISH (15%) 和培养 (8%) 相比,BALF的模具检测率优越 (26%)
在BALF (47%) 中,AspergillusDNA的检测频率高于血清 (17%),而在Mucorales检测中,BALF (9%) 和血清 (8%) 之间没有显著差异.
在BALF中同时发现了Aspergillus和Mucorales的DNA,这表明真菌感染频繁.

结论:

用BALF进行的特定qPCR测定是检测疑似真菌性肺炎的癌症患者中Aspergillus和Mucorales最敏感的方法.
鱼类可以预测后续的阳性真菌培养物,而BALF的qPCR突出显示了真菌共感染的潜力.
仅仅依靠血清检测可能导致错过诊断,特别是粘膜菌,这强调了BALF分析对最佳患者护理的重要性.

关键词:

亚斯伯吉洛症 (Aspergillosis) 是一种疾病.在BALF中,我们可以看到.在CMV中使用CMV.鱼类鱼类是一种鱼类.这是一个PCRPCR.癌症癌症癌症癌症癌症粘膜性肌肉病的发生.

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