title: Study on invasive fungal infections in immunocompromised patients to present a suitable early diagnostic procedure.
abstract: OBJECTIVE
  The incidence of invasive fungal infections has increased considerably in recent years. The aim of this study was to present a suitable early diagnostic procedure in immunocompromised patients, using a molecular assay.
  
  
  METHODS
  From September 2005 to January 2007, 310 immunosuppressed patients were followed for fungal infections for a 6-month period. EDTA-anticoagulant whole blood specimens were collected prospectively once per week and stored at -20 degrees C until use in molecular assays.
  
  
  RESULTS
  Molecular assays were positive in 55 (17.7%) patients. The etiologic agents were Candida albicans (67.3%), Aspergillus flavus (20.0%), Aspergillus fumigatus (7.3%), Candida tropicalis (3.6%), and Candida krusei (1.8%). The sensitivity, specificity, and positive and negative predictive values of PCR-ELISA with proven and probable invasive fungal infections were 84.6%, 92.7%, 75.3%, and 95.8%, respectively. The results showed that the mean clinical manifestation time was 38.96 days and the mean time of positivity of the molecular test (time of infection) was 17.69 days. A linear model for predicted infection and clinical manifestation time was found to be as follows: Y=11.64+1.147X, r(2)=0.812, where Y is the time at presentation of clinical signs and X is the time of infection (positive PCR-ELISA result).
  
  
  CONCLUSIONS
  It may be concluded that the molecular assay would help in the diagnosis of invasive fungal infections at the early stage of infection, before clinical manifestations.
authors.affiliation: Department of Medical Parasitology and Mycology, School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences, Tehran, Iran. Badieep@yahoo.com
authors.forename: Parisa
authors.initials: P
authors.lastname: Badiee
authors.forename: Parivash
authors.initials: P
authors.lastname: Kordbacheh
authors.forename: Abdolvahab
authors.initials: A
authors.lastname: Alborzi
authors.forename: SeyedAli
authors.initials: S
authors.lastname: Malekhoseini
authors.forename: Mani
authors.initials: M
authors.lastname: Ramzi
authors.forename: Hossain
authors.initials: H
authors.lastname: Mirhendi
authors.forename: Mahmood
authors.initials: M
authors.lastname: Mahmoodi
authors.forename: Elaheh
authors.initials: E
authors.lastname: Shakiba
mesh_terms: D001228:Aspergillosis / Q000175:diagnosis* / Q000382:microbiology; D001231:Aspergillus flavus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D001232:Aspergillus fumigatus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D002175:Candida / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D002177:Candidiasis / Q000175:diagnosis* / Q000382:microbiology; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods*; D006801:Humans; D016867:Immunocompromised Host; D016533:Mycological Typing Techniques; D009181:Mycoses; D016133:Polymerase Chain Reaction / Q000379:methods*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013997:Time Factors