Molecular Techniques for Genus and Species Determination of Fungi From Fresh and Paraffin-Embedded Formalin-Fixed Tissue in the Revised EORTC/MSGERC Definitions of Invasive Fungal Infection

Author:

Lockhart Shawn R1,Bialek Ralf2,Kibbler Christopher C3,Cuenca-Estrella Manuel4,Jensen Henrik E5,Kontoyiannis Dimitrios P6

Affiliation:

1. Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA

2. LADR GmbH MVZ Dr. Kramer und Kollegen, Geesthacht, Germany

3. Centre for Medical Microbiology, University College London, UK

4. Laboratorio de referencia e investigación en Micología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Spain

5. Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark

6. Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA

Abstract

Abstract The EORTC/MSGERC have revised the definitions for proven, probable, and possible fungal diseases. The tissue diagnosis subcommittee was tasked with determining how and when species can be determined from tissue in the absence of culture. The subcommittee reached a consensus decision that polymerase chain reaction (PCR) from tissue, but not immunohistochemistry or in situ hybridization, can be used for genus or species determination under the new EORTC/MSGERC guidelines, but only when fungal elements are identified by histology. Fungal elements seen in tissue samples by histopathology and identified by PCR followed by sequencing should fulfill the definition of a proven fungal infection, identified to genus/species, even in the absence of culture. This summary discusses the issues that were deliberated by the subcommittee to reach the consensus decision and outlines the criteria a laboratory should follow in order to produce data that meet the EORTC/MSGERC definitions.

Funder

National Institutes of Health

National Cancer Institute

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Microbiology (medical)

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