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2014, Number 1

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Cir Cir 2014; 82 (1)

Molecular markers: an important tool in the diagnosis, treatment and epidemiology of invasive aspergillosis

Frías-de León MG, Acosta-Altamirano G, Duarte-Escalante E, Martínez-Hernández JE, Martínez-Rivera MÁ, Reyes-Montes MR

Language: Spanish
References: 44
Page: 109-118
PDF size: 387.70 Kb.


ABSTRACT

Increase in the incidence of invasive aspergillosis has represented a difficult problem for management of patients with this infection due to its high rate of mortality, limited knowledge concerning its diagnosis, and therapeutic practice. The difficulty in management of patients with aspergillosis initiates with detection of the fungus in the specimens of immunosuppressed patients infected with Aspergillus fumigatus; in addition, difficulty exists in terms of the development of resistance to antifungals as a consequence of their indiscriminate use in prophylactic and therapeutic practice and to ignorance concerning the epidemiological data of aspergillosis. With the aim of resolving these problems, molecular markers is employed at present with specific and accurate results. However, in Mexico, the use of molecular markers has not yet been implemented in the routine of intrahospital laboratories; despite the fact that these molecular markers has been widely referred in the literature, it is necessary for it to validated and standardized to ensure that the results obtained in any laboratory would be reliable and comparable. In the present review, we present an update on the usefulness of molecular markers in accurate identification of A. fumigatus, detection of resistance to antifugal triazoles, and epidemiological studies for establishing the necessary measures for prevention and control of aspergillosis.


REFERENCES

  1. Kriengkauykiat J, Ito JI, Dadwal SS. Epidemiology and treatment approaches in management of invasive fungal infections. Clin Epidemiol 2011;3:175-191.

  2. Bow EJ. Considerations in the approach to invasive fungal infection in patients with haematological malignancies. Br J Haematol 2008;140:133-152.

  3. Nivoix Y, Velten M, Letscher-Bru V, Moghaddam A, Natarajan- Amé S, Fohrer C, et al. Factors Associated with Overall and Attributable Mortality in Invasive Aspergillosis. Clin Infect Dis 2008;47:1176-1184.

  4. Valdez JM, Scheinberg P, Nunez O, Wu CO, Young NS, Walsh TJ. Decreased Infection-Related Mortality and Improved Survival in Severe Aplastic Anemia in the Past Two Decades. Clin Infect Dis 2011;52:726-735.

  5. Pagano L, Caira M, Candoni A, Offidani M, Fianchi L, Martino B, et al. The epidemiology of fungal infections in patients with hematologic malignancies: the SEIFEM-2004 study. Haematologica 2006;91:1068-1075.

  6. Arza FS, Coria Lorenzo JJ, Rosales Uribe RE, Gómez Barreto D. Aspergilosis invasiva en el paciente pediátrico oncológico: Revisión del tema a propósito de un caso. Rev Enfer Infec Pediatr 2006;9:80-92.

  7. Reséndiz J. Utilidad de la detección de galactomananos por ensayo inmunoenzimático para el diagnóstico de aspergilosis invasiva en pacientes neutropénicos ingresados en el Hospital Infantil de México Federico Gómez. Tesis de Maestría. ENCB del IPN, México 2010.

  8. Latgé JP. The pathobiology of Aspergillus fumigatus. Trends Microbiol 2001;9:382-389.

  9. Alcazar-Fuoli L, Mellado E, García-Effron G, Lopez JF, Grimalt JO, Cuenca-Estrella JM, et al. Ergosterol biosynthesis pathway in Aspergillus fumigatus. Steroids 2008;73:339- 347.

  10. Leenders AC, Van Belkum A, Behrendt M, Luijendijk A, Verbrugh HA. Density and Molecular Epidemiology of As pergillus in Air and Relationship to Outbreaks of Aspergillus Infection. J Clin Microbiol 1999;37:1752-1757.

  11. Bart-Delabesse E, Humbert JF, Delabesse É, Bretagne S. Microsatellite Markers for Typing Aspergillus fumigatus Isolates. J Clin Microbiol 1998;36:2413-2418.

  12. Varga J. Mating type gene homologues in Aspergillus fumigatus. Microbiology 2003;149:816-819.

  13. Kami M, Fukui T, Ogawa S, Kazuyama Y, Machida U, Tanaka Y, et al. Use of Real-Time PCR on Blood Samples for Diagnosis of Invasive Aspergillosis. Clin Infect Dis 2001;33:1504-1512.

  14. Rantakokko-Jalava K, Laaksonen S, Issakainen J, Vauras J, Nikoskelainen J, Viljanen MK, et al. Semiquantitative Detection by Real-Time PCR of Aspergillus fumigatus in Bronchoalveolar Lavage Fluids and Tissue Biopsy Specimens from Patients with Invasive Aspergillosis. J Clin Microbiol 2003;41:4304-4311.

  15. Spiess B, Buchheidt D, Baust C, Skladny H, Seifarth W, Zeilfelder U, et al. Development of a LightCycler PCR Assay for Detection and Quantification of Aspergillus fumigatus DNA in Clinical Samples from Neutropenic Patients. J Clin Microbiol 2003;41:1811-1818.

  16. Buitrago MJ, Gómez-López A, Mellado E, Rodríguez- Tudela JL, Cuenca-Estrella M. Detección de Aspergillus spp mediante PCR en tiempo real en un modelo murino de infección pulmonar. Enferm Infecc Microbiol Clin 2005;23:464-468.

  17. Scotter JM, Chambers ST. Comparison of Galactomannan Detection, PCR-Enzyme-Linked Immunosorbent Assay, and Real-Time PCR for Diagnosis of Invasive Aspergillosis in a Neutropenic Rat Model and Effect of Caspofungin Acetate. Clin Diagn Lab Immunol 2005;12:1322-1327.

  18. Baskova L, Landlinger C, Preuner S, Lion T. The Pan-AC assay: a single-reaction real-time PCR test for quantitative detection of a broad range of Aspergillus and Candida species. J Med Microbiol 2007;56:1167-1173.

  19. Serrano R, Gusmão L, Amorim A, Araujo R. Rapid identification of Aspergillus fumigatus within the section Fumigati. BMC Microbiology 2011;11:82 (consultado 2011 Oct 8). Disponible en http://www.biomedcentral.com/1471-2180/11/82

  20. Balajee SA, Gribskov JL, Hanley E, Nickle D, Marr KA. Aspergillus lentulus sp. Nov., a New Sibling Species of A. fumigatus. Eukaryot Cell 2005;4:625-632.

  21. Denning DW, Venkateswarin K, Oakley L, Anderson MJ, Manning NJ, Stevens DA, et al. Itraconazole resistance in Aspergillus fumigatus. Antimicrob Agents Chemother 1997;41:1364- 1368.

  22. Howard SJ, Cerar D, Anderson MJ, Albarrag A, Fisher MC, Pasqualotto AC, et al. Frequency and Evolution of Azole Resistance in Aspergillus fumigatus Associated with Treatment Failure. Emerg Infect Dis 2009;15:1068-1076.

  23. Lai CC, Tan CK, Huang YT, Shao PL, Hsueh PR. Current challenges in the management of invasive fungal infections. J Infect Chemother 2008;14:77-85.

  24. Garcia-Effron G, Dilger A, Alcazar-Fuoli L, Park S, Mellado E, Perlin DS. Rapid detection of triazole antifungal resistance in Aspergillus fumigatus. J Clin Microbiol 2008;46:1200- 1206.

  25. Mortensen KL, Mellado E, Lass-Flörl C, Rodriguez-Tudela JL, Johansen HK, Arendrup MC. Environmental Study of Azole-Resistant Aspergillus fumigatus and Other Aspergilli in Austria, Denmark, and Spain. Antimicrob Agents Chemother 2010;54:4545-4549.

  26. Howard SJ, Arendrup MC. Acquired antifungal drug resistance in Aspergillus fumigatus: epidemiology and detection. Med Mycol 2011;49(Suppl 1):S90-95.

  27. Díaz-Guerra TM, Mellado E, Cuenca-Estrella M, Rodríguez- Tudela JL. A Point Mutation in the 14α-Sterol Demethylase Gene cyp51A Contributes to Itraconazole Resitance in Aspergillus fumigatus. Antimicrob Agents Chemother 2003;47:1120-1124.

  28. Mellado E, García-Effron G, Alcázar-Fuoli L, Cuenca-Estrella M, Rodríguez-Tudela JL. Substitutions at Methionine 220 in the 14α-Sterol Demethylase (Cyp51A) of Aspergillus fumigatus Are Responsible for Resistance In Vitro to Azole Antifungal Drugs. Antimicrob Agents Chemother 2004;48:2747-2750.

  29. Balashov SV, Gardiner R, Park S, Perlin DS. Rapid, High- Throughput, Multiplex, Real-Time PCR for Identification of Mutations in the cyp51A Gene of Aspergillus fumigatus That Confer Resistance to Itraconazole. J Clin Microbiol 2005;43:214-222.

  30. Mellado E, Garcia-Effron G, Alcázar-Fuoli L, Melchers WJ, Verweij PE, Cuenca-Estrella M, et al. A New Aspergillus fumigatus Resistance Mechanism Conferring In Vitro Cross- Resistance to Azole Antifungals Involves a Combination of cyp51A Alterations. Antimicrob Agents Chemother 2007;51:1897-1904.

  31. Klaassen CH, de Valk HA, Curfs-Breuker IM, Meis JF. Novel mixed-format real-time PCR assay to detect mutations conferring resistance to triazoles in Aspergillus fumigatus and prevalence of multi-triazole resistance among clinical isolates in the Netherlands. J Antimicrob Chemother 2010;65:901-905.

  32. Camps SMT, van der Linden JWM, Li Y, Kuijper E, van Dissel JT, Verweij PE, et al. Rapid Induction of Multiple Resistance Mechanism in Aspergillus fumigatus during Azole Therapy: a Case Study and Review of the Literature. Antimicrob Agents Chemother 2012;56:10-16.

  33. Escribano P, Recio S, Peláez T, Bouza E, Guinea J. Aspergillus fumigatus Strains with Mutations in the cyp51A Gene Do Not Always Show Phenotypic Resistance to Itraconazole, Voriconazole, or Posaconazole. Antimicrob Agents Chemother 2011;55:2460-2462.

  34. Lasker BA. Evaluation of Performance of Four Genotypic Methods for Studying the Genetic Epidemiology of Aspergillus fumigatus Isolates. J Clin Microbiol 2002;40:2886-2892.

  35. Bain JM, Tavanti A, Davidson AD, Jacobsen MD, Shaw D, Gow NAR, et al. Multilocus Sequence Typing of the Pathogenic Fungus Aspergillus fumigatus. J Clin Microbiol 2007;45:1469-1477.

  36. Hurst SF, Kidd SE, Morrissey CO, Snelders E, Melchers WJG, Castelli MV, et al. Interlaboratory Reproducibility of a Single-Locus Sequence-Based Method for Strain Typing of Aspergillus fumigatus. J Clin Mirobiol 2009;47:1562-1564.

  37. Henry T, Iwen PC, Hinrichs SH. Identification of Aspergillus species using internal transcribed spacer regions 1 and 2. J Clin Microbiol 2000;38:1510-1515.

  38. Bertout S, Renaud F, Barton R, Symoens F, Burnod J, Piens MA, et al. Genetic Polymorphism of Aspergillus fumigatus in Clinical Samples from Patients with Invasive Aspergillosis: Investigation Using Multiple Typing Methods. J Clin Microbiol 2001;39:1731-1737.

  39. Rosehart K, Richards MH, Bidochka MJ. Microsatellite analysis of environmental and clinical isolates of the opportunist fungal pathogen Aspergillus fumigatus. J Med Microbiol 2002;51:1128-1134.

  40. Warris A, Klaassen CHW, Meis JFGM, de Ruiter MT, de Valk HA, Abrahamsen TG, et al. Molecular Epidemiology of Aspergillus fumigatus Isolates Recovered from Water, Air, and Patients Shows Two Clusters of Genetically Distinct Strains. J Clin Microbiol 2003;41:4101-4106.

  41. de Valk HA, Meis JFGM, de Pauw BE, Donnelly PJ, Klaassen CHW. Comparison of Two Highly Discriminatory Molecular Fingerprinting Assays for Analysis of Multiple Aspergillus fumigatus Isolates from Patients with Invasive Aspergillosis. J Clin Microbiol 2007;45:1415-1419.

  42. Yaguchi T, Oiré Y, Tanaka R, Matsuzawa T, Ito J, Nishimura K. Molecular Phylogenetics of Multiple Genes on Aspergillus Section Fumigati Isolated from Clinical Specimens in Japan. Jpn J Med Mycol 2007;48:37-46.

  43. Balajee SA, Tay ST, Lasker BA, Hurst SF, Rooney AP. Characterization of a Novel Gene Strain Typing Reveals Substructuring of Aspergillus fumigatus across North America. Eukaryot Cell 2007;6:1392-1399.

  44. Duarte-Escalante E, Zúñiga G, Nava Ramírez O, Córdoba S, Refojo N, Arenas R, et al. Population structure and diversity of the pathogenic fungus Aspergillus fumigatus isolated from different sources and geographic origins. Mem Inst Oswaldo Cruz, Rio de Janeiro 2009;104:427- 433.




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