4.7 Article

Detection and investigation of invasive mould disease

Journal

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
Volume 66, Issue -, Pages i15-i24

Publisher

OXFORD UNIV PRESS
DOI: 10.1093/jac/dkq438

Keywords

galactomannan; beta-d-glucan; PCR-based diagnosis; microscopic examination; cultures

Funding

  1. Pfizer
  2. Pfizer International Operations
  3. Pfizer Inc.
  4. Astellas Pharma
  5. bioMerieux
  6. Gilead Sciences
  7. Schering Plough
  8. Soria Melguizo SA
  9. European Union
  10. ALBAN program
  11. Spanish Agency for International Cooperation
  12. Spanish Ministry of Culture and Education
  13. Spanish Health Research Fund
  14. Instituto de Salud Carlos III
  15. Ramon Areces Foundation
  16. Mutua Madrilena Foundation
  17. Austrian Science Fund (FWF) [P174840]
  18. MFF Tirol
  19. Merck Sharp
  20. Dohme
  21. Ministry of Health of the Czech Republic
  22. Schering-Plough/MSD

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A comprehensive review of diagnostic techniques for opportunistic systemic mycoses focused on invasive mould disease in immunocompromised patients is presented. We first analysed conventional diagnostic methods, such as microscopy examination, culture and radiology, underlining their limitations, which have led to the development of alternative methods, such as the detection of fungal components. Among these we highlight fungal antigen and DNA quantification, which make it possible to detect infections early and start appropriate treatment. We also briefly review the methods for carrying out susceptibility tests for antifungal drugs, including reference procedures, commercial techniques and their indications. Furthermore, we analyse the recommendations for therapeutic drug monitoring of antifungal agents in body fluids.

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