Abstract
When a diagnosis of invasive candidiasis has been made, treatment with toxic fungicidal agents is inevitable. The crucial decision of when to stop such treatment is difficult to make, because cultures are often negative despite ongoing invasive candidiasis and can therefore not be used as a reliable parameter of effective therapy. In the present study, the use of PCR in monitoring the therapeutic efficacy of antifungal treatment with liposomal amphotericin B was evaluated by using neutropenic mice with systemic candidiasis. Blood cultures of infected mice treated with different doses of liposomal amphotericin B were only positive at the early onset of the infection process and became sterile within 3 days; this was true even with mice treated with 1 mg of liposomal amphotericin B per kg of body weight that experienced a relapse of infection 14 days later. A significant correlation between presence of Candida albicans in the kidneys and PCR results obtained with blood was demonstrated. Thus, PCR results obtained with blood samples correlated well with the therapeutic efficacy of antifungal treatment.
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- Berenguer J., Buck M., Witebsky F., Stock F., Pizzo P. A., Walsh T. J. Lysis-centrifugation blood cultures in the detection of tissue-proven invasive candidiasis. Disseminated versus single-organ infection. Diagn Microbiol Infect Dis. 1993 Aug-Sep;17(2):103–109. doi: 10.1016/0732-8893(93)90020-8. [DOI] [PubMed] [Google Scholar]
- Buchman T. G., Rossier M., Merz W. G., Charache P. Detection of surgical pathogens by in vitro DNA amplification. Part I. Rapid identification of Candida albicans by in vitro amplification of a fungus-specific gene. Surgery. 1990 Aug;108(2):338–347. [PubMed] [Google Scholar]
- De Repentigny L., Kaufman L., Cole G. T., Kruse D., Latgé J. P., Matthews R. C. Immunodiagnosis of invasive fungal infections. J Med Vet Mycol. 1994;32 (Suppl 1):239–252. doi: 10.1080/02681219480000871. [DOI] [PubMed] [Google Scholar]
- Holmes A. R., Cannon R. D., Shepherd M. G., Jenkinson H. F. Detection of Candida albicans and other yeasts in blood by PCR. J Clin Microbiol. 1994 Jan;32(1):228–231. doi: 10.1128/jcm.32.1.228-231.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hopwood V., Warnock D. W. New developments in the diagnosis of opportunistic fungal infection. Eur J Clin Microbiol. 1986 Aug;5(4):379–388. doi: 10.1007/BF02075691. [DOI] [PubMed] [Google Scholar]
- Kan V. L. Polymerase chain reaction for the diagnosis of candidemia. J Infect Dis. 1993 Sep;168(3):779–783. doi: 10.1093/infdis/168.3.779. [DOI] [PubMed] [Google Scholar]
- Matthews R. C. Early diagnosis of systemic candidal infection. J Antimicrob Chemother. 1993 Jun;31(6):809–812. doi: 10.1093/jac/31.6.809. [DOI] [PubMed] [Google Scholar]
- Mitchell T. G., Sandin R. L., Bowman B. H., Meyer W., Merz W. G. Molecular mycology: DNA probes and applications of PCR technology. J Med Vet Mycol. 1994;32 (Suppl 1):351–366. doi: 10.1080/02681219480000961. [DOI] [PubMed] [Google Scholar]
- Miyakawa Y., Mabuchi T., Fukazawa Y. New method for detection of Candida albicans in human blood by polymerase chain reaction. J Clin Microbiol. 1993 Dec;31(12):3344–3347. doi: 10.1128/jcm.31.12.3344-3347.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Niesters H. G., Goessens W. H., Meis J. F., Quint W. G. Rapid, polymerase chain reaction-based identification assays for Candida species. J Clin Microbiol. 1993 Apr;31(4):904–910. doi: 10.1128/jcm.31.4.904-910.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Reiss E., Morrison C. J. Nonculture methods for diagnosis of disseminated candidiasis. Clin Microbiol Rev. 1993 Oct;6(4):311–323. doi: 10.1128/cmr.6.4.311. [DOI] [PMC free article] [PubMed] [Google Scholar]
- van Deventer A. J., Goessens W. H., van Belkum A., van Vliet H. J., van Etten E. W., Verbrugh H. A. Improved detection of Candida albicans by PCR in blood of neutropenic mice with systemic candidiasis. J Clin Microbiol. 1995 Mar;33(3):625–628. doi: 10.1128/jcm.33.3.625-628.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
- van Etten E. W., van den Heuvel-de Groot C., Bakker-Woudenberg I. A. Efficacies of amphotericin B-desoxycholate (Fungizone), liposomal amphotericin B (AmBisome) and fluconazole in the treatment of systemic candidosis in immunocompetent and leucopenic mice. J Antimicrob Chemother. 1993 Nov;32(5):723–739. doi: 10.1093/jac/32.5.723. [DOI] [PubMed] [Google Scholar]
- van der Vliet G. M., Schukkink R. A., van Gemen B., Schepers P., Klatser P. R. Nucleic acid sequence-based amplification (NASBA) for the identification of mycobacteria. J Gen Microbiol. 1993 Oct;139(10):2423–2429. doi: 10.1099/00221287-139-10-2423. [DOI] [PubMed] [Google Scholar]