{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T22:17:37Z","timestamp":1790115457503,"version":"4.0.1"},"reference-count":34,"publisher":"American Society for Microbiology","issue":"5","license":[{"start":{"date-parts":[[2013,5,1]],"date-time":"2013-05-01T00:00:00Z","timestamp":1367366400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Eukaryot Cell"],"published-print":{"date-parts":[[2013,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            <jats:named-content content-type=\"genus-species\">Exserohilum rostratum<\/jats:named-content>\n            was the major cause of an outbreak of fungal infections linked to injections of contaminated methylprednisolone acetate. Because almost 14,000 persons were exposed to product that was possibly contaminated with multiple fungal pathogens, there was unprecedented need for a rapid throughput diagnostic test that could detect both\n            <jats:named-content content-type=\"genus-species\">E. rostratum<\/jats:named-content>\n            and other unusual agents of fungal infection. Here we report development of a novel PCR test that allowed for rapid and specific detection of fungal DNA in cerebrospinal fluid (CSF), other body fluids and tissues of infected individuals. The test relied on direct purification of free-circulating fungal DNA from fluids and subsequent PCR amplification and sequencing. Using this method, we detected\n            <jats:named-content content-type=\"genus-species\">Exserohilum rostratum<\/jats:named-content>\n            DNA in 123 samples from 114 case-patients (28% of 413 case-patients for whom 627 samples were available), and\n            <jats:named-content content-type=\"genus-species\">Cladosporium<\/jats:named-content>\n            DNA in one sample from one case-patient. PCR with novel\n            <jats:named-content content-type=\"genus-species\">Exserohilum<\/jats:named-content>\n            -specific ITS-2 region primers detected 25 case-patients with samples that were negative using broad-range ITS primers. Compared to fungal culture, this molecular test was more sensitive: of 139 case-patients with an identical specimen tested by culture and PCR,\n            <jats:named-content content-type=\"genus-species\">E. rostratum<\/jats:named-content>\n            was recovered in culture from 19 (14%), but detected by PCR in 41 (29%), showing a diagnostic sensitivity of 29% for PCR compared to 14% for culture in this patient group. The ability to rapidly confirm the etiologic role of\n            <jats:named-content content-type=\"genus-species\">E. rostratum<\/jats:named-content>\n            in these infections provided an important contribution in the public health response to this outbreak.\n          <\/jats:p>","DOI":"10.1128\/ec.00046-13","type":"journal-article","created":{"date-parts":[[2013,3,2]],"date-time":"2013-03-02T10:10:29Z","timestamp":1362219029000},"page":"677-683","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":73,"title":["Detection of Fungal DNA in Human Body Fluids and Tissues during a Multistate Outbreak of Fungal Meningitis and Other Infections"],"prefix":"10.1128","volume":"12","author":[{"given":"Lalitha","family":"Gade","sequence":"first","affiliation":[{"name":"Mycotic Diseases Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina M.","family":"Scheel","sequence":"additional","affiliation":[{"name":"Mycotic Diseases Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cau D.","family":"Pham","sequence":"additional","affiliation":[{"name":"Mycotic Diseases Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark D.","family":"Lindsley","sequence":"additional","affiliation":[{"name":"Mycotic Diseases Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naureen","family":"Iqbal","sequence":"additional","affiliation":[{"name":"Mycotic Diseases Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela Ahlquist","family":"Cleveland","sequence":"additional","affiliation":[{"name":"Mycotic Diseases Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne M.","family":"Whitney","sequence":"additional","affiliation":[{"name":"Bacterial Special Pathogens Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shawn R.","family":"Lockhart","sequence":"additional","affiliation":[{"name":"Mycotic Diseases Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary E.","family":"Brandt","sequence":"additional","affiliation":[{"name":"Mycotic Diseases Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasia P.","family":"Litvintseva","sequence":"additional","affiliation":[{"name":"Mycotic Diseases Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1212292"},{"key":"e_1_3_2_3_2","first-page":"842","article-title":"Multistate fungal meningitis outbreak: interim guidance for treatment","volume":"61","author":"Centers for Disease Control and Prevention","year":"2012","unstructured":"Centers for Disease Control and Prevention. 2012. Multistate fungal meningitis outbreak: interim guidance for treatment. MMWR Morb. Mortal. Wkly. Rep. 61:842.","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-158-3-201302050-00568"},{"key":"e_1_3_2_5_2","volume-title":"Update: additional contamination identified in medical products from New England Compounding Center, Health Alert Network","author":"Centers for Disease Control and Prevention","year":"2012","unstructured":"Centers for Disease Control and Prevention. 2012. Update: additional contamination identified in medical products from New England Compounding Center, Health Alert Network, vol HAN-0337. CDC, Atlanta, GA."},{"key":"e_1_3_2_6_2","article-title":"Fungal infections associated with contaminated methylprednisolone injections: preliminary report","author":"Smith RM","year":"2012","unstructured":"SmithRM SchaeferMK KainerMA WiseM FinksJ DuwveJ FontaineE ChuA CarothersB ReillyA FiedlerJ WieseAD FeasterC GibsonL GrieseS PurfieldA ClevelandAA BenedictK HarrisJR BrandtME BlauD JerniganJ WeberJT ParkBJ, Multistate Fungal Infection Outbreak Response Team. 2012. Fungal infections associated with contaminated methylprednisolone injections: preliminary report. N. Engl. J. Med. [Epub ahead of print.]","journal-title":"N. Engl. J. Med."},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1212972"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-006-0093-3"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.24.2.250-259.1986"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00488-12"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1080\/02681218780000571"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.4103\/0377-4929.97896"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1470.2012.01829.x"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00466-06"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc062547"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.4038\/cmj.v51i4.1142"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2012.03808.x"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2000-9394"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2012.11.003"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1590\/S0100-879X2010007500067"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3062.2011.00608.x"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.028399-0"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.03369-12"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.es.22.110191.002521"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1080\/13693780701449425"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.2144\/01305st05"},{"key":"e_1_3_2_27_2","unstructured":"Clinical and Laboratory Standards Institute. 2008. Interpretive criteria for identification of bacteria and fungi by DNA target sequencing; approved guideline MM18-A. Clinical and Laboratory Standards Institute Wayne PA."},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.2004.024703"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00074-09"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1003037"},{"key":"e_1_3_2_31_2","first-page":"839","article-title":"Multistate outbreak of fungal infection associated with injection of methylprednisolone acetate solution from a single compounding pharmacy\u2013United States, 2012","volume":"61","author":"Centers for Disease Control and Prevention","year":"2012","unstructured":"Centers for Disease Control and Prevention. 2012. Multistate outbreak of fungal infection associated with injection of methylprednisolone acetate solution from a single compounding pharmacy\u2013United States, 2012. MMWR Morb. Mortal. Wkly. 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