Author/Authors :
Ashrafi ، M نويسنده Student research committee, Mazandaran University of Medical Sciences, Sar i, Iran , , Nabili، M نويسنده Social Security Organization, Golestan, Iran , , Shokohi ، T نويسنده Invasive Fungi Research Center (IFRC), and Department of Medical Parasitology and Mycology, Mazandaran University of Medical Sciences, Sari, Iran , , Janbabaie ، G نويسنده Department of Internal Medicine, Cell and Molecular Bi ology Research Center , Mazandaran University of Medical Sciences, Sari, Iran , , Hedayati ، MT نويسنده nvasive Fungi Research Center, Mazand aran University of Medical Sciences, Sari, Iran , , Ali - Moghaddam ، K نويسنده Hematology - Oncology Research Center and Stem Cell Transplantation Research Center (HORCSCT), Tehran University of Medical Sciences, Iran ,
Abstract :
Background and Purpose:
Invasive candidiasis (IC) is a significant cause of morbidity and mortality in patients with
hematologic disorders and bone marrow transplan
t recipients. Rapid, specific and sensitive test for the timely accuracy
in immunocompromised patients to reduce mortality rates and prevent IC progress is necessary. We established a real
-
time PCR assay on blood for the diagnosis and differentiation of th
e causative
Candida
species
.
Materials and Methods:
Whole blood samples were collected twice, from 72 patients for Real Time PCR and blood
culture assays. The primers and hybridization probes were designed to potentiate the specific sequence of 18S rRNA
ge
nes using Light Cycler system and Fluorescence Resonance Energy Transfer (FERT). The patients with hematologic
malignancies and bone marrow transplant recipients were evaluated for IC based on the revised European Organization
for Research and Treatment of
Cancer/ Mycoses Study Group (EORTC/MSG) criteria
.
Results:
From 2009 to 2011, 72 patients with hematologic malignancies and bone marrow transplant recipients were
evaluated for IC. The female to male ratio was 27:45; the mean age was 32.1 years. The most
common malignancy in this
patient was acute myeloid leukemia (AML) (27.8%) and acute lymphoblastic leukemia (ALL) (26.4%). Out of 72 patients,
11 patients (15.3%) had positive real time PCR /probe results. Based on the melting temperature (Tm) analysis, 5
(45.4%)
C. krusei
, 3 (27.2%)
C. tropicalis
, 2 (18.1%)
C. parapsilosis
and 1
C. albicans
(9%) were identified. According to the
revised EORTC
/
MSG, 1 patient (9%) and 10 patients (91%) were defined as proven and possible groups of IC,
respectively.
The mo
rtality rate in proven and possible IC patient was found 54.5%.
Conclusion:
The established Real
-
time PCR/FRET probe assay is an appropriate diagnostic tool for the detection of
Candida
species DNA and the management of patients suffering from hematologic
malignancies and bone marrow
recipient are at risk for IC
.
