Evaluation of Mass Spectrometry-Based Detection of Panfungal Serum Disaccharide for Diagnosis of Invasive Fungal Infections: Results from a Collaborative Study Involving Six European Clinical Centers

Marjorie Cornu (1) , Boualem Sendid (1) , Alexandre Mery (2) , Nadine François (1) , Malgorzata Mikulska (3) , Valérie Letscher-Bru (4) , Elena de Carolis (5) , Lauro Damonti (6) , Marie Titecat (1) , Pierre-Yves Bochud (6) , Alexandre Alanio (7, 8) , Maurizio M. Sanguinetti (5) , Claudio Viscoli (3) , Raoul Herbrecht (9) , Yann Guerardel (2) , Daniel Poulain (1)

1 LIRIC - Lille Inflammation Research International Center - U 995
2 UGSF - Unité de Glycobiologie Structurale et Fonctionnelle - UMR 8576
3 Ospedale Policlinico San Martino [Genoa]
4 IPPTS - Institut de Parasitologie et de Pathologie Tropicale
5 Fondazione Policlinico Universitario Agostino Gemelli IRCCS
6 CHUV - Centre Hospitalier Universitaire Vaudois = Lausanne University Hospital [Lausanne]
7 Mycologie moléculaire - Molecular Mycology
8 Hôpital Saint-Louis
9 IRFAC - Inserm U1113 - Interface de Recherche Fondamentale et Appliquée en Cancérologie

A mass spectrometry (MS) method that detects a serum disaccharide (DS) (MS-DS) was recently described for the diagnosis of invasive fungal infections (IFI). We carried out a European collaborative study to evaluate this assay. Patients with the following IFI were selected according to the availability of sera obtained at about the time that IFI was documented: invasive candidiasis (IC; n ϭ 26 patients), invasive aspergillosis (IA; n ϭ 19), and mucormycosis (MM; n ϭ 23). Control sera originated from 20 neutropenic patients and 20 patients with bacteremia. MS-DS was carried out in blind manner for the diagnosis of IFI. A diagnosis of IC or IA was confirmed by detection of mannan (Man) or galactomannan (GM), respectively, associated with detection of (1,3)-␤-D-glucan (BDG) in both infections. MM was detected by quantitative real-time PCR (qPCR). All tests discriminated sera from patients with IC from sera from control subjects with bacteremia (P Յ 0.0009). For IC, the MS-DS sensitivity and specificity were 51% and 87%, respectively. MS-DS complemented the high specificity of Man monitoring. All tests discriminated sera from IA patients from sera from neutropenic controls (P Յ 0.0009). For IA, MS-DS sensitivity and specificity were 64% and 95%, respectively. Only 13/36 serum samples from patients with MM were concordant by MS-DS and qPCR (6 were positive, and 7 were negative); 14 were positive by MS-DS alone. qPCR and MS-DS made a similar contribution to the diagnosis of MM. In patients undergoing long-term monitoring, the persistent circulation of serum disaccharide was observed, whereas DNA was detected only for a short period after initiation of treatment. MS-DS has an important role to play in the early diagnosis of IFI. Its panfungal nature and complementarity with other tests may justify its use in the management of IFI.

Mots clés: invasive aspergillosis; invasive candidiasis; invasive fungal infection; mass spectrometry; mucormycosis; serological diagnosis

Domaines: Biologie structurale [q-bio.BM]

Marjorie Cornu, Boualem Sendid, Alexandre Mery, Nadine François, Malgorzata Mikulska, et al.. Evaluation of Mass Spectrometry-Based Detection of Panfungal Serum Disaccharide for Diagnosis of Invasive Fungal Infections: Results from a Collaborative Study Involving Six European Clinical Centers. Journal of Clinical Microbiology, 2019, 57 (5), ⟨10.1128/JCM.01867-18⟩. ⟨hal-02371912⟩