Piluca MD (@pilukaid-md.bsky.social)

Molecular diagnostics in cancer patients with suspected respiratory mold infections | Journal of Clinical Microbiology Mold pneumonia is a serious complication in cancer patients. Reliable detection of etiologic agents is critical for patient care, but optimal testing strategies are undefined. We performed a prospective study comparing molecular tests (specific and unspecific qPCR and FISH) and culture on bronchoalveolar lavage fluid (BALF) and serum, focusing on aspergillosis and mucormycosis to gain insights into mold detection in high-risk patients. We demonstrate that FISH visualizes fungal elements in BALF, predominantly conidia, suggesting recent fungal exposure or failure to clear inhaled conidia at the time of diagnostic testing. We find that specific qPCRs from BALF are the most sensitive method to detect Aspergillus and Mucorales, superior to broad-range qPCR, culture, and testing of serum. Importantly, Mucorales DNA is mostly co-detected with Aspergillus, suggesting co-infections. Although DNA detection in serum is more likely in mucormycosis than in aspergillosis, sole serum testing may miss mucormycosis, precluding optimal patient care. https://journals.asm.org/doi/10.1128/jcm.01201-25