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Detection of Fungal DNA in Human Body Fluids and Tissues during a Multistate Outbreak of Fungal Meningitis and Other Infections

Lalitha Gade, Christina M. Scheel, Cau D. Pham, Mark D. Lindsley, Naureen Iqbal, Angela Ahlquist Cleveland, Anne M. Whitney, Shawn R. Lockhart, Mary E. Brandt, Anastasia P. Litvintseva
Lalitha Gade
aMycotic Diseases Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Christina M. Scheel
aMycotic Diseases Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Cau D. Pham
aMycotic Diseases Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Mark D. Lindsley
aMycotic Diseases Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Naureen Iqbal
aMycotic Diseases Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Angela Ahlquist Cleveland
aMycotic Diseases Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Anne M. Whitney
bBacterial Special Pathogens Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Shawn R. Lockhart
aMycotic Diseases Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Mary E. Brandt
aMycotic Diseases Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Anastasia P. Litvintseva
aMycotic Diseases Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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DOI: 10.1128/EC.00046-13
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    Fig 1

    LOD of PCR detection. Serial dilutions of DNA of E. rostratum (A and B), C. cladosporioides (C), and R. laryngis (D) were subjected to DNA purification, PCR, and sequencing. Panels A, C, and D show results of the agarose gel with PCR products obtained using ITS3/4 primers, and panel B shows PCR results obtained using Exserohilum-specific primers. The numbers on the top of the gel depict concentrations of genomic DNA in grams per milliliter.

Tables

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  • Table 1

    Results of PCR and DNA sequencing presented by patient and by sample

    Results for:No. testedNo. positive (%)c
    All case patientsa413115 (28)
        CSF34583 (24)
        Synovial fluids153 (20)
        Abscess aspirates62 (33)
        Tissues7127 (38)
    All samples627124 (20)
        CSF50691 (18)
        Synovial fluids183 (17)
        Abscess aspirates72 (29)
        Tissuesb9628 (29)
    • ↵a Each case-patient is counted once. Note that some case-patients had more than one specimen type.

    • ↵b FFPE samples are excluded.

    • ↵c These values include 114 case-patients with E. rostratum and 1 case-patient with Cladosporium sp.

  • Table 2

    Comparison of PCR results among serially collected CSF samples (n = 73 case-patients)

    Sample typeNo. tested
    Serial samples have the same results52
        All positive5
        All negative47
    Serial samples have different results21
        First sample positive, then negative16
        First sample negative, then positive5
  • Table 3

    Comparison between PCR and culture results (n = 139 case-patients)

    Results categorized by test performedNo. positive (%)
    PCR positive only27 (19)
    Culture positive only5 (4)
    Positive by both PCR and culture14 (10)
    All PCR positive41 (29)
    All culture positive19 (14)
    Positive by either method46 (33)
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Detection of Fungal DNA in Human Body Fluids and Tissues during a Multistate Outbreak of Fungal Meningitis and Other Infections
Lalitha Gade, Christina M. Scheel, Cau D. Pham, Mark D. Lindsley, Naureen Iqbal, Angela Ahlquist Cleveland, Anne M. Whitney, Shawn R. Lockhart, Mary E. Brandt, Anastasia P. Litvintseva
Eukaryotic Cell Apr 2013, 12 (5) 677-683; DOI: 10.1128/EC.00046-13

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Detection of Fungal DNA in Human Body Fluids and Tissues during a Multistate Outbreak of Fungal Meningitis and Other Infections
Lalitha Gade, Christina M. Scheel, Cau D. Pham, Mark D. Lindsley, Naureen Iqbal, Angela Ahlquist Cleveland, Anne M. Whitney, Shawn R. Lockhart, Mary E. Brandt, Anastasia P. Litvintseva
Eukaryotic Cell Apr 2013, 12 (5) 677-683; DOI: 10.1128/EC.00046-13
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