Utility of nested polymerase chain reaction for fungus in detecting clinically suspected patients of invasive fungal infections and its clinical correlation and comparison with fungal culture

J Family Med Prim Care. 2020 Sep 30;9(9):4992-4997. doi: 10.4103/jfmpc.jfmpc_775_20. eCollection 2020 Sep.

ABSTRACT

AIMS AND OBJECTIVES: The aim and objective of this study is to detect invasive fungal infections (IFIs) early and with more sensitivity by the nested polymerase chain reaction (PCR) for fungus as compared to fungal culture in clinically suspected patients and also explore its correlation in reference to age, duration of symptoms, immunocompromised status, and other risk factors predisposing to IFIs.

MATERIALS AND METHODS: In this cross-sectional study, 50 suspected patients admitted in medical acute care unit/intensive care unit (ACU/ICU) of Sir Sunderlal Hospital, Banaras Hindu University, Varanasi, India, comprised the study. All cases were selected based on the predefined inclusion and exclusion criteria. A detailed history, clinical examination, and all required investigations were done in all suspected patients. Blood samples were taken for nested-PCR for fungus and culture. Nested PCR was performed on extracted DNA form samples collected from all participants under the study.

RESULTS: Our study comprised of 50 suspected immunocompromised patients of IFIs. Among the participants under the study, the most common risk factor was diabetes mellitus (28% cases). Nearly two-thirds (60%) of the cases were 50 years or more. Around 70% of the cases had a history of illness more than 2 weeks. Nested PCR for fungus came out to be positive in 21/50 patients (42%); however, fungal culture was positive in none. Among the admitted patient in ACU/ICU, 75% were neutropenic.

CONCLUSIONS: IFIs are more common in immunocompromised individuals, patients with comorbidities, long history of symptoms, and elderly population. Nested PCR for fungus has a high sensitivity (as compared to the fungal culture), and also they are rapid in giving the results. Thus, nested PCR for fungus can be used in a cost-effective manner for the early and reliable diagnosis of clinically suspected IFIs.

PMID:33209834 | PMC:PMC7652180 | DOI:10.4103/jfmpc.jfmpc_775_20