Comparison of histopathological analysis, culture, and polymerase chain reaction assays to detect XXXX from biopsy specimens.

@entity1 @entity13296 @entity281 @entity2381 @entity3
BACKGROUND: With the advent of new antifungal agents, the identification of a causative pathogen is crucial to guide the antifungal treatment of @entity3 . However, tissue cultures often fail to grow a fungal pathogen in cases of suspected @entity281 . METHODS: In a prospective multicenter study, we compared the results of histopathological analysis, culture, and 2 seminested polymerase chain reaction assays identifying Aspergillus species and Zygomycetes as causative agents of @entity3 using respiratory tract biopsy samples obtained from 56 immunocompromised @entity1 who had suspected @entity281 . RESULTS: Mold hyphae were detected histopathologically in 27 (48%) of the tissue specimens. Hyphae corresponded to either @entity2381 (n=18) or @entity13296 (n=6) or could not be further specified (n=3). A mold was cultured from 14 of 18 samples with aspergillus hyphae, 2 of 6 samples with Zygomycetes hyphae, and 1 of 3 samples with unspecified hyphae. Polymerase chain reaction was superior to culture in detecting the infecting mold (26 of 27 samples vs. 17 of 27 samples, respectively; P=.006) from histopathologically positive samples. Genus or species identification by sequencing of the polymerase chain reaction products were in accordance with culture results in 16 of 18 culture-positive samples. Both polymerase chain reaction assays failed to detect fungal DNA in 1 sample that had unspecified hyphae and negative culture results. CONCLUSION: The PCR assays offer a reliable etiologic diagnosis that is superior to culture in @entity1 with proven @entity3 . This may improve @entity1 management through tailored antifungal therapy when cultures fail to grow a pathogen.
