Early diagnosis and monitoring of XXXX by detection of circulating DNA in serum: retrospective analysis of 44 cases collected through the French Surveillance Network of Invasive Fungal Infections (RESSIF).

@entity1 @entity2583 @entity24408
UNASSIGNED: The main objective of this study was to assess the diagnostic performance of a set of three Mucorales quantitative PCR assays in a retrospective multicentre study. @entity2583 cases were recorded thanks to the French prospective surveillance programme (RESSIF network). The day of sampling of the first histological or mycological positive specimen was defined as day 0 (D0). Detection of circulating DNA was performed on frozen serum samples collected from D-30 to D30, using quantitative PCR assays targeting Rhizomucor, Lichtheimia, Mucor/Rhizopus. Forty-four @entity1 diagnosed with probable (n  =  19) or proven (n  =  25) @entity2583 were included. Thirty-six of the 44 @entity1 (81%) had at least one PCR-positive serum. The first PCR-positive sample was observed 9  days (range 0-28  days) before diagnosis was made using mycological criteria and at least 2  days (range 0-24  days) before imaging. The identifications provided with the quantitative PCR assays were all concordant with culture and/or PCR-based identification of the causal species. Survival rate at D84 was significantly higher for @entity1 with an initially positive PCR that became negative after treatment initiation than for @entity1 whose PCR remained positive (48% and 4%, respectively; p <10(-6)). The median time for complete negativity of PCR was 7  days (range 3-19  days) after initiation of @entity24408 treatment. Despite some limitations due to the retrospective design of the study, we showed that Mucorales quantitative PCR could not only confirm the @entity2583 diagnosis when other mycological arguments were present but could also anticipate this diagnosis. Quantification of DNA loads may also be a useful adjunct to treatment monitoring.
