PCR和mNGS诊断侵袭性曲霉病和毛霉病的研究进展

Advances in research on PCR and mNGS in diagnosing invasive aspergillosis and mucormycosis

  • 摘要: 侵袭性真菌主要包括曲霉、毛霉、念珠菌、隐球菌及肺孢子菌等,其中曲霉和毛霉感染是导致IFD高病死率的主要病原体。传统诊断方法如真菌培养、组织病理学检查等存在灵敏度低、检测时间长等局限性,难以满足临床早期诊断的需求。目前临床亟需高灵敏度、高特异性的分子诊断方法,以区分定植与侵袭性感染,并适用于多种样本(如体液、组织、血液等)。此外,理想的检测技术还应具备低成本、易维护及可迭代更新的特点。聚合酶链式反应(PCR)和宏基因组二代测序(mNGS)作为新兴分子诊断技术,凭借其高敏感性和特异性,在侵袭性曲霉病和毛霉病的诊断中展现出显著优势。本文综述PCR和mNGS在侵袭性曲霉病和毛霉病诊断中的应用现状、优势、局限性以及未来发展方向,并进行展望。

     

    Abstract: Major invasive fungi include Aspergillus, Mucor, Candida, Cryptococcus and Pneumocystis, with Aspergillus and Mucor being the primary pathogens contributing to high mortality in IFD. Traditional diagnosic methods such as fungal culture and histopathological test are difficult to meet the requirement for early diagnosis due to their limitations like low sensitivity and long test time. There is an urgent clinical need for molecular diagnostic methods with high sensitivity and specificity to differentiate colonization from invasive infection, applicable to various samples (e.g., body fluids, tissues, blood). Additionally, ideal detective technologies should have the characteric of low cost, easy maintenance, and iterative updatability. As emerging molecular diagnostic technologies, polymerase chain reaction (PCR) and metagenomic next-generation sequencing (mNGS) demonstrate significant advantages in diagnosing invasive aspergillosis and mucormycosis due to their high sensitivity and specificity. This paper reviews the current applications, advantages, limitations and future directions of PCR and mNGS in diagnosing invasive aspergillosis and mucormycosis, providing insights into their potential.

     

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