Investigating the presence of fungal agents in febrile neutropenic patients using different microbiological, serological, and molecular methods

  • Ahu Sönmez Department of Medical Microbiology, Faculty of Medicine, Gaziantep University, Gaziantep
  • Fahriye Eksi Department of Medical Microbiology, Faculty of Medicine, Gaziantep University, Gaziantep
  • Mustafa Pehlivan Department of Haematology, Faculty of Medicine, Gaziantep University, Gaziantep
  • Handan Haydaroglu Sahin Department of Haematology, Faculty of Medicine, Gaziantep University, Gaziantep
Keywords: febrile neutropenia, invasive fungal infection, culture, PCR, galactomannan

Abstract

This study aimed to investigate fungal agents in febrile neutropenic patients with hematological malignancies. Direct microscopy and cultures were performed on clinical samples collected from febrile neutropenic episodes. The galactomannan (GM) antigen was tested using enzyme-linked immunosorbent assays, and Aspergillus fumigatus and Candida albicans deoxyribonucleic acid (DNA) assessed using real-time polymerase chain reaction (PCR) in consecutive serum samples. Of the 199 episodes investigated, 1.5% were classified as definite invasive aspergillosis (IA), 4.0% as IA with high probability, and 4.0% as IA with low probability. Additionally, candidaemia was detected in eight episodes (4.1%). The GM antigen was found negative for 86.4% of episodes, as one positive for 7.0% of episodes, as two or more consecutive positives for 5.5% of episodes, and as positive in any two serum samples in 1.0% of episodes. While no C. albicans DNA was detected in 98.5% of 199 episodes, one positive result was obtained in 1.0% of episodes, and two or more consecutive positives in 0.5% of episodes. A. fumigatus PCR results were found negative in 81.9% of episodes, as one positive in 16.1% of episodes, as positive in any two serum samples in 1.0% of episodes, and consecutively positive in 1.0% of episodes. GM antigen tests were found consecutively positive in all three patients diagnosed as having definite IA. These findings indicate that conventional, serological, and molecular methods should be used in combination to detect fungal agents in febrile neutropenic patients.

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Author Biographies

Fahriye Eksi, Department of Medical Microbiology, Faculty of Medicine, Gaziantep University, Gaziantep
Faculty of Medicine, Medical Microbiology Department
Mustafa Pehlivan, Department of Haematology, Faculty of Medicine, Gaziantep University, Gaziantep
Faculty of Medicine, Department of Haematology
Handan Haydaroglu Sahin, Department of Haematology, Faculty of Medicine, Gaziantep University, Gaziantep
Faculty of Medicine, Department of Haematology

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Published
2015-07-27
How to Cite
1.
Sönmez A, Eksi F, Pehlivan M, Haydaroglu Sahin H. Investigating the presence of fungal agents in febrile neutropenic patients using different microbiological, serological, and molecular methods. Bosn J of Basic Med Sci [Internet]. 2015Jul.27 [cited 2019Jun.18];15(3):40-7. Available from: http://www.bjbms.org/ojs/index.php/bjbms/article/view/409
Section
Microbiology