الفهرس 
? Invasive Fungal Infection in Immunocompromised PatientsOnly 14 pages are availabe for public view
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Abstract
Background: The prevalence of invasive fungal infections has increased in recent years due to an increasing population of immunocompromised patients. Invasive fungal infections (IFI) are a significant cause of morbidity and mortality in the immunocompromised patients. The current study was aimed to evaluate the role of real-time PCR using a pan-fungal marker as a rapid test for the early diagnosis of invasive fungal infection in patients with hematological malignancy. The study was conducted at Ain Shams University hospitals as case-control study. Cases group comprised of eighty (80) patients diagnosed with hematological malignancy and control group comprised of twenty (20) patients with non invasive fungal infection with medical condition other than hematological malignancies. The specimens were collected over the period between October 2015 to September 2016.All subjects underwent blood culture, real time (RT) PCR and High Resolution Melting (HRM) PCR for identification of fungal species.
Results: PCR was positive in the 2 confirmed cases (100%), showed detection rate of 57.9 % and 80 % among probable cases in EORTC/MSG Consensus group definitions in 2002 and 2008 respectively and 47.5% and 70.4% among possible cases in 2002 and 2008 definition respectively. According to 2002 definition all 80 cases are suspected to have invasive fungal infection (IFI) with PCR detection rate 51.2% but according to 2008 definition the clinically suspected cases to have IFI are 39 cases with Panfungal PCR detection rate of 74.4%. HRM identified the fungal species to be 51.2% Candida albicans, 44% Non Candida albicans Candida and 4.9% Mucor. In addition PCR was negative among control group. Blood culture was positive in 2 patients with AML, both isolates were Candida albicans, the result was not statistically significant. There was a highly significant rate of fungal detection using real-time PCR technique than by using blood culture technique (p=<0.001).
Conclusion: Real-time PCR using panfungal marker is a rapid, sensitive and superior to the blood culture technique in detection of invasive fungal infections and the use of HRM-PCR is a specific test for species identification.