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Open AccessArticle

Impact of ITS-Based Sequencing on Antifungal Treatment of Patients with Suspected Invasive Fungal Infections

1
Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz 8010, Austria
2
Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz 8010, Austria
3
BioTechMed-Graz, Graz 8010, Austria
4
Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz 8010, Austria
5
Division of General Paediatrics, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz 8010, Austria
6
Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, San Diego, CA 92093, USA
*
Author to whom correspondence should be addressed.
J. Fungi 2020, 6(2), 43; https://doi.org/10.3390/jof6020043 (registering DOI)
Received: 8 February 2020 / Revised: 14 March 2020 / Accepted: 25 March 2020 / Published: 27 March 2020
(This article belongs to the Special Issue Molecular Diagnostics of Fungal Infections)
Molecular techniques including the sequencing of fungal-specific DNA targets are increasingly used in the diagnosis of suspected invasive fungal infections. In contrast to established biomarkers like galactomannan or 1-3-β-d-glucan, the clinical impact of these methods remains unknown. We retrospectively investigated the impact of ITS1-sequencing on antifungal treatment strategies in 71 patients (81 samples) with suspected invasive fungal infections. ITS-sequencing either confirmed already ongoing antifungal therapy (19/71 patients, 27%), led to a change in antifungal therapy (11/71, 15%) or supported the decision to withhold antifungal treatment (34/71, 48%) (in seven of 71 patients, ITS-sequencing results were obtained postmortem). ITS-sequencing results led to a change in antifungal therapy in a relevant proportion of patients, while it confirmed therapeutic strategies in the majority. Therefore, ITS-sequencing was a useful adjunct to other fungal diagnostic measures in our cohort.
Keywords: invasive fungal infections; ITS-sequencing; antifungal therapy invasive fungal infections; ITS-sequencing; antifungal therapy
MDPI and ACS Style

Guenter, S.; Gorkiewicz, G.; Halwachs, B.; Kashofer, K.; Thueringer, A.; Wurm, P.; Zollner-Schwetz, I.; Valentin, T.; Prattes, J.; Wunsch, S.; Ullrich, E.; Zurl, C.; Hoenigl, M.; Krause, R. Impact of ITS-Based Sequencing on Antifungal Treatment of Patients with Suspected Invasive Fungal Infections. J. Fungi 2020, 6, 43.

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