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Evaluation of a digital microfluidic real-time PCR platform to detect DNA of Candida albicans in blood.

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Date
2012-09
Authors
Schell, WA
Benton, JL
Smith, PB
Poore, M
Rouse, JL
Boles, DJ
Johnson, MD
Alexander, BD
Pamula, VK
Eckhardt, AE
Pollack, MG
Benjamin, DK
Perfect, JR
Mitchell, TG
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(14 total)
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Abstract
Species of Candida frequently cause life-threatening infections in neonates, transplant and intensive care unit (ICU) patients, and others with compromised host defenses. The successful management of systemic candidiasis depends upon early, rapid diagnosis. Blood cultures are the standard diagnostic method, but identification requires days and less than half of the patients are positive. These limitations may be eliminated by using real-time polymerase chain reaction (PCR) to detect Candida DNA in the blood specimens of patients at risk. Here, we optimized a PCR protocol to detect 5-10 yeasts in low volumes of simulated and clinical specimens. We also used a mouse model of systemic candidiasis and determined that candidemia is optimally detectable during the first few days after infection. However, PCR tests are often costly, labor-intensive, and inconvenient for routine use. To address these obstacles, we evaluated the innovative microfluidic real-time PCR platform (Advanced Liquid Logic, Inc.), which has the potential for full automation and rapid turnaround. Eleven and nine of 16 specimens from individual patients with culture-proven candidemia tested positive for C. albicans DNA by conventional and microfluidic real-time PCR, respectively, for a combined sensitivity of 94%. The microfluidic platform offers a significant technical advance in the detection of microbial DNA in clinical specimens.
Type
Journal article
Subject
Animals
Candida albicans
Candidemia
Clinical Laboratory Techniques
Disease Models, Animal
Humans
Mice
Microfluidics
Real-Time Polymerase Chain Reaction
Sensitivity and Specificity
Permalink
https://hdl.handle.net/10161/11061
Published Version (Please cite this version)
10.1007/s10096-012-1561-6
Publication Info
Schell, WA; Benton, JL; Smith, PB; Poore, M; Rouse, JL; Boles, DJ; ... Mitchell, TG (2012). Evaluation of a digital microfluidic real-time PCR platform to detect DNA of Candida albicans in blood. Eur J Clin Microbiol Infect Dis, 31(9). pp. 2237-2245. 10.1007/s10096-012-1561-6. Retrieved from https://hdl.handle.net/10161/11061.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
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Scholars@Duke

Alexander

Barbara Dudley Alexander

Professor of Medicine
Clinical research related to infectious complications of solid organ and bone marrow transplantation, with a particular interest in the treatment and rapid diagnosis of fungal disease.
Benjamin

Daniel Kelly Benjamin Jr.

Kiser-Arena Distinguished Professor
Dr. Danny Benjamin is the Principal Investigator and Chair of the National Institute of Child Health and Human Development’s Pediatric Trials Network. The Network is responsible for designing and leading clinical trials of off-patent medicines in children of all ages across all therapeutic areas. The team has established, or is actively studying, the correct dosing and safety of more than 70 of the most commonly used medicines in children. E

Melissa DePaoli Johnson

Associate Professor in Medicine
Prognostic indicators for patients with Candida spp. bloodstream infections Antifungal pharmacokinetics/pharmacodynamics Immunogenetics among patients with candidiasis Management of the HIV infected patient and antiretroviral pharmacotherapy Antibacterial drug utilization, resistance, and appropriate prescribingAntimicrobial Stewardship
Mitchell

Thomas Greenfield Mitchell

Associate Professor Emeritus in Molecular Genetics and Microbiology
Among patients with AIDS, leukemia or other cancers, organ or bone marrow transplants, and similar immunocompromising risk factors, the incidence of opportunistic mycoses and the number of different fungal pathogens are increasing dramatically. For many of these fungi, the definition of a species and the recognition of pathogen are highly problematic. Conventional methods of identification are based on morphological and physiological characteristics and are often time-consuming, difficult
Perfect

John Robert Perfect

James B. Duke Distinguished Professor of Medicine
Research in my laboratory focuses around several aspects of medical mycology. We are investigating antifungal agents (new and old) in animal models of candida and cryptococcal infections. We have examined clinical correlation of in vitro antifungal susceptibility testing and with in vivo outcome. Our basic science project examines the molecular pathogenesis of cryptococcal infections. We have developed a molecular foundation for C. neoformans, including transformation systems, gene disr
Schell

Wiley Alexander Schell

Associate Professor Emeritus in Medicine
Smith

Phillip Brian Smith

Samuel L. Katz Distinguished Professor of Pediatrics
Dr. Smith completed his residency in pediatrics and a fellowship in neonatal medicine at Duke University Medical Center in 2004 and 2007, respectively. He completed an MHS in clinical research from Duke University in 2006 and an MPH in biostatistics from the University of North Carolina at Chapel Hill in 2009. His research is focused on pediatric drug safety, neonatal pharmacology, and the epidemiology of neonatal infections. Dr. Smith is or has been the protocol chair for more than 14 studie
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