UF to lead research on life-threatening fungus

"Historically, our only means of diagnosing these infections has been by growing the organism from patient's specimens in the laboratory and then having it identified by an experienced mycologist," said Barbara D. Alexander, M.D., the project's co-principal investigator and director of transplant infectious diseases services and the clinical mycology laboratory at Duke University Medical Center. "These conventional methods for diagnosing fungal disease are slow and lack sensitivity. Furthermore, many times the patients are too sick to tolerate the invasive procedures, such as lung biopsy, in order to obtain the samples for laboratory testing."

Wingard said two-thirds of the time tests are negative even though patients have the infection.

"That's the biggest challenge - we may suspect patients have the infection but we can't really know with certainty from currently available tests whether they truly are infected or not," he said. "We end up making clinical decisions about using drugs that may be toxic or using the wrong drugs in patients when we are not sure whether they have this deadly infection."

Officials are hoping to collect samples from about 200 patients a year for the next seven years to better characterize the fungus and improve the diagnostic accuracy and speed of tests used to detect aspergillosis. The repository will include samples from patients with confirmed infections that will be compared with samples from patients whose diagnosis is less clear and with samples from patients who are at high-risk but not infected.

Researchers also will work with Emory University, Indianapolis-based MiraVista Diagnostics, and the University of Manchester in England to evaluate existing tests and develop new, more accurate and less invasive ones.

While more potent treatment regimens are improving prospects for patients, so-called emerging pathogens -- viruses, bacteria and fungi -- are a growing medical problem, Wingard said.

"With advancing medical technology and more powerful antibiotics, patients are living longer," he said. "We have a growing population of patients who are susceptible to very serious infections by viruses, bacteria and fungi that in years past were not medical problems."

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