Developments in novel breath tests for bacterial and fungal pulmonary infection.

Chambers ST, Scott-Thomas A, Epton M.

Source

aDepartment of Pathology, University of Otago, Christchurch bDepartment of Infectious Diseases cDepartment of Respiratory Medicine, Christchurch Hospital, Christchurch, New Zealand.

Abstract

PURPOSE OF REVIEW:

Breath testing has developed over the last 20 years. New techniques that can identify fingerprints for specific diseases and specific markers of respiratory pathogens have been applied to breath analysis. This review discusses the recent advances in breath analysis for the diagnosis of bacterial and fungal lower respiratory tract infections.

RECENT FINDINGS:

The current techniques continue to develop rapidly, but preconcentration techniques are needed to analyse many target volatile organic compounds for most systems. Breath testing with an electronic nose is promising for the diagnosis of tuberculosis (TB), and specific volatiles identifiable by gas chromatography with mass spectrometry have been identified in breath for Mycobacterium tuberculosis, Pseudomonas aeruginosa and Aspergillus fumigatus, but are found at very low concentrations in breath. Contamination from the environment is an ongoing confounding influence. Exhaled breath condensate (EBC) is disappointing as a diagnostic sample.

SUMMARY:

Careful attention needs to be paid to the sensitivity and specificity of a technique and confounding from the environment. The role of technologies such as selected ion flow tube-mass spectrometry is emerging. The electronic nose requires further validation for TB. The identification of specific microbial biomarkers aids the quest for improved accuracy. EBC is currently of limited value.

Lippincott, Williams & Wilkins

Shedding natural light on fungal infections.

Vecchiarelli A, d’Enfert C.

Source

Department of Experimental Medicine and Biochemical Science; Microbiology Section; Perugia, Italy.

Abstract

Bioluminescence imaging allows the visualization of the temporal and spatial progression of biological phenomena, in particular infection, by non-invasive methods in vivo. This nature-borrowed technology has been successfully used to monitor bacterial infections but recent studies have also succeeded in tracking fungal infections such as those caused by the two major opportunistic fungal pathogens Candida albicans and Aspergillus fumigatus. The findings of Donat and collaborators published in this issue now show that by combining the sensitivity of the Gaussia princeps luciferase with a surface display expression system it is possible to perform longitudinal infection studies on cutaneous forms of aspergillosis with a small number of animals. Besides providing new and valuable information in the field of aspergillosis, the findings of Donat et al. offer a new perspective on the general applicability of bioluminescence methodologies for eukaryotic pathogens where the bacterial lux operon cannot be exploited.

Landis Bioscience

Triple fungal infection in a patient with liver cirrhosis.

Feb 2012

Alidjinou K, Mathieu D, Colombel JF, François N, Poulain D, Sendid B.

Source

Laboratoire de parasitologie-mycologie, Institut de microbiologie, Centre de biologie pathologie.

Abstract

Keywords : triple fungal infection, Candida albicans, Aspergillus fumigatus, Pneumocystis jirovecci, liver cirrhosis

The prevalence of invasive mycoses is increasing, especially among patients who are immunocompromised or hospitalized with serious underlying diseases. Such infections are associated with a high morbidity and significant mortality, requiring early diagnosis and appropriate treatment but also an optimal prophylaxis in patients with high risk factors. We report a case of triple fungal infection including an invasive pulmonary aspergillosis by Aspergillus fumigatus, a candidemia by Candida albicans and a Pneumocystis pneumonia. The overall clinical picture of this patient was liver cirrhosis with medical history of immunosuppressive treatment for Crohn disease and a non-hodgkin lymphoma. There was no antifungal prophylaxis for this patient. Under treatment, the issue was unfavourable with multivisceral failure.

John Libbey Eurotext