The incidence of invasive fungal infections is on the rise worldwide due to the growth of the immunocompromised population. We report here the use of a diagnostic assay that utilizes a universal extraction method, broad spectrum PCR amplification and analysis via electrospray ionization mass spectrometry (PCR/ESI-MS) to detect and identify more than 200 pathogenic fungi directly from bronchoalveolar lavage (BAL) specimens in less than 8 hours. In this study, we describe both analytical and clinical performance of the assay, when run with prospectively collected clinical BAL specimens. In 146 patients with probable and possible fungal infections defined by EORTC/MSG (European Organization for Research and Treatment of Cancer/Mycoses Study Group) criteria, the PCR/ESI-MS assay demonstrated a sensitivity of 90.9% (95% CI: 76.4-96.9%) and a specificity of 82.3% (95% CI: 74.2-88.2%). This data demonstrates the utility of a non-culture based broad fungal targets molecular diagnostic tool for rapid and accurate diagnosis of invasive fungal infections in patients at risk of developing fungal diseases.

中文翻译：

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直接从前瞻性收集的支气管肺泡灌洗标本中检测和鉴定真菌病原体的PCR电喷雾电离质谱平台的评估。

由于免疫受损人群的增长，侵袭性真菌感染的发生率在全世界范围内都在上升。我们在此报告诊断方法的使用，该方法利用通用提取方法，广谱PCR扩增和通过电喷雾电离质谱（PCR / ESI-MS）进行分析，以直接从支气管肺泡灌洗液（BAL）中检测和鉴定200多种致病真菌标本不到8小时。在这项研究中，我们描述了使用前瞻性收集的临床BAL标本进行分析时的分析和临床性能。根据EORTC / MSG（欧洲癌症研究和治疗组织/真菌病研究组）标准定义的146例可能的和可能的真菌感染患者中，PCR / ESI-MS分析的敏感性为90.9％（95％CI：76.4- 96。9％）和82.3％（95％CI：74.2-88.2％）的特异性。该数据证明了基于非培养物的广泛的真菌靶标分子诊断工具可用于快速，准确地诊断处于患真菌病风险的患者中的侵袭性真菌感染。