Mucormycosis in Patients with Hematological Malignancies Based on a Polymerase Chain Reaction

Background and Objectives: Mucormycosis is a critical infection in patients with hematological malignancies and mainly categorized by rapid progression and high mortality. Determination of mucormycosis by the routine clinical methods is very challenging. This study aimed to screen the clinical samples from patients with hematological malignancies with suspected mucormycosis by a semi-nested polymerase chain reaction (PCR). Materials and Methods: Overall, we collected 228 samples from patients with hematologic malignancies from two educational hospitals in Shiraz. Patients were suspected of having mucormycosis and clinical samples consisted of blood, bronchoalveolar lavage, sputum, tissue and fluids. DNA was extracted from the clinical samples and a semi-nested PCR using ZM1, ZM2 and ZM3 primers was carried out to detect DNA from Mucorales. Results: According to the demographic data, the mean age of patients was 39 years with 57% male. The semi-nested PCR detected the presence of Mucorales DNA in 26 (11.4%) patients. Among those with PCR positive results, eight (30%) had received voriconazole which might have increased the risk of mucormycosis. Five patients with PCR positive results died. Conclusion: Mucormycosis is the third common fungal infection in patients with hematologic malignancies, due to the lack of a valid diagnostic assay. PCR-based molecular techniques can serve as promising tools for early detection of mucormycosis. An early diagnostic method and appropriate antifungal therapy are crucial to successful management.