Comparison of 21-Plex PCR and API 20C AUX, MALDI-TOF MS, and rDNA Sequencing for a Wide Range of Clinically Isolated Yeast Species: Improved Identification by Combining 21-Plex PCR and API 20C AUX as an Alternative Strategy for Developing Countries

dc.contributor.authorArastehfar, Amir
dc.contributor.authorDaneshnia, Farnaz
dc.contributor.authorKord, Mohammad
dc.contributor.authorRoudbary, Maryam
dc.contributor.authorZarrinfar, Hossein
dc.contributor.authorFang, Wenjie
dc.contributor.authorHashemi, Sayed Jamal
dc.contributor.authorNajafzadeh, Mohammad Javad
dc.contributor.authorKhodavaisy, Sadegh
dc.contributor.authorPan, Weihua
dc.contributor.authorLiao, Wanqing
dc.contributor.authorBadali, Hamid
dc.contributor.authorRezaie, Sassan
dc.contributor.authorZomorodian, Kamiar
dc.contributor.authorHagen, Ferry
dc.contributor.authorBoekhout, Teun
dc.creator.orcidhttps://orcid.org/0000-0002-6010-8414en_US
dc.date.accessioned2023-06-20T19:26:23Z
dc.date.available2023-06-20T19:26:23Z
dc.date.issued2019-02-15
dc.description.abstractOccurrence of non-Candida albicans Candida (NCAC) species that are associated with elevated MIC values and therapeutic failures are increasing. As a result, timely and accurate means of identification to the species level is becoming an essential part of diagnostic practices in clinical settings. In this study, 301 clinically isolated yeast strains recovered from various anatomical sites [Blood (n = 145), other sites (n = 156)] were used to assess the accuracy and practicality of API 20C AUX and 21-plex PCR compared to MALDI-TOF MS and large subunit rDNA (LSU rDNA). MALDI-TOF MS correctly identified 98.33% of yeast isolates, 100% of top five Candida species, 95.7% of rare yeast species, while 1.3% of isolates were misidentified. API 20C AUX correctly identified 83.7% of yeast isolates, 97.2% of top five Candida species, 61.8% of rare yeast species, while 16.2% of yeast isolates were misidentified. The 21-plex PCR, accurately identified 87.3% of yeast isolates, 100% of top five Candida species, 72% of rare yeast species, but it misidentified 1.3% of rare yeast species while 9.9% of whole yeast isolates were not identified. The combination of rapidity of 21-plex PCR and comprehensiveness of API 20C AUX, led to correct identification of 92% of included yeast isolates. Due to expensiveness of MALDI-TOF MS and sequencing, this combination strategy could be the most accurate and inexpensive alternative identification strategy for developing countries. Moreover, by the advent and development of cost-effective, reliable, and rapid PCR machines that cost 130 US dollars, 21-plex could be integrated in routine laboratories of developing and resource-limited countries to specifically identify 95% causative agents of yeast-related infections in human. Databases of MALDI-TOF MS, API 20C AUX, and the number of target species identified by 21-plex require further improvement to keep up with the diverse spectrum of yeast species.en_US
dc.description.departmentMolecular Microbiology and Immunologyen_US
dc.description.sponsorshipEuropean Union's Horizon 2020 research and innovation program; National Health Department of China; National Natural Science Foundation of China; Second Military Medical University; Shanghai Science and Technology Committee; Tehran University of Medical Sciences & Health Servicesen_US
dc.identifier.citationArastehfar, A., Daneshnia, F., Kord, M., Roudbary, M., Zarrinfar, H., Fang, W., . . . Boekhout, T. (2019). Comparison of 21-Plex PCR and API 20C AUX, MALDI-TOF MS, and rDNA Sequencing for a Wide Range of Clinically Isolated Yeast Species: Improved Identification by Combining 21-Plex PCR and API 20C AUX as an Alternative Strategy for Developing Countries. Frontiers in Cellular and Infection Microbiology, 9. doi:10.3389/fcimb.2019.00021en_US
dc.identifier.issn2235-2988
dc.identifier.otherhttps://doi.org/10.3389/fcimb.2019.00021
dc.identifier.urihttps://hdl.handle.net/20.500.12588/1908
dc.language.isoen_USen_US
dc.publisherFrontiers Mediaen_US
dc.rightsAttribution 3.0 United States*
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/us/*
dc.subjectAPI 20C AUXen_US
dc.subject21-plex PCRen_US
dc.subjectMALDI-TOF MSen_US
dc.subjectLSU rDNA sequencingen_US
dc.subjectdeveloping countriesen_US
dc.titleComparison of 21-Plex PCR and API 20C AUX, MALDI-TOF MS, and rDNA Sequencing for a Wide Range of Clinically Isolated Yeast Species: Improved Identification by Combining 21-Plex PCR and API 20C AUX as an Alternative Strategy for Developing Countriesen_US
dc.typeArticleen_US

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