Mikolojik klinik tanıda moleküler teknikler

Year 2015, Volume: 72 Issue: 3, 263 - 272, 01.09.2015

Nuri Kiraz

Abstract

Mantar hastalıklarının tanımı, özellikle bağışıklığı baskılanmış hastalarda bir sorun olmaya devam etmektedir. klinik yönleri genellikle özgül değidir, başka mikroorganizmalar tarafından da oluşturulabilir ve kolonizasyonu invaziv hastalıktan ayırt etmek güçtür. Mevcut tanım yöntemleri ekseri duyarlılıktan yoksundur. Böylece, sistemik mantar enfeksiyonlarının erken tanımı için çeşitli tanım yöntemlerinin birlikte kullanılması gerekmektedir. Mikroskop incelemesi, kültüre dayalı yöntemler, antijen aranması ve moleküler teknikler tanımı kolaylaştırabilir ve hızlandırabilir. Klinik örnekte bulunan mantarın belirlenmesi ve tanımlanması için nükleik asit amplifikasyon teknolojisi, özgül problar ve nükleik asit sekanslama moleküler teknikleri çok hızla gelişmektedir. Ancak hangisinin en uygun olduğunu belirlemek için henüz karşılaştırmalı çalışmalar bulunmamaktadır ve bugüne kadar testlerin standartlaştılması geliştirilememiştir. Dolayısıyla, moleküler testlerin rutin laboratuvarlarda kullanılabilmesi için önce geçerli kılınmalarına ve standartlaştırılmalarına gereksinim bulunmaktadır

Keywords

Mantar enfeksiyonları moleküler tanı, mantarın tanımı, mantarların moleküler tiplendirilmesi

Molecular techniques for clinical diagnostic mycology

Abstract

Diagnosing fungal infections remains a problem, particularly in the immunocompromised patient. The clinical manifestations of invasive fungal infections are usually not specific and can be produced by other organisms and colonization is difficult to distinguish from invasive disease. Existing diagnostic tools often lack sensitivity. Thus, the combination of various diagnostic tools is mandatory to allow earlier diagnosis of systemic fungal infections. Microscopy, culture based methods, antigen detection, and molecular techniques may help to facilitate and accelerate the diagnosis. Molecular methods are being developed for the detection and identification of fungi present in clinical samples at a very fast rate, whether it is done by nucleic acid amplification technology or by specific probes or nucleic acid sequencing. However, no comparative studies have been done to determine which are optimal and no standards for testing have been developped to date. Therefore, extensive validation and standardization is needed, before molecular assays can be used in a routine laboratory

Keywords

Molecular diagnosis of fungal infections, fungus identification, molecular typing

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