Blood mucorales quantitative PCR ready for prime time.

PURPOSE OF REVIEW: Mucorales quantitative PCR (qPCR) was first developed and evaluated in 2013, and since then, substantial evidence has accumulated supporting its clinical utility. This review highlights the major advances this technique has brought to the management of mucormycosis.

RECENT FINDINGS: Different in-house and commercial assays are now available, targeting a broad range of clinically relevant Mucorales species. Performance depends strongly on preanalytical parameters such as volume of plasma or serum used for DNA extraction, and ratio of DNA input in the PCR reaction mix. Multiplex assays have expanded diagnostic scope to include Aspergillus and other molds, supporting differential diagnosis of invasive mold infections. Serial qPCR monitoring provides prognostic information, with DNA clearance after treatment associated with improved survival. Routine screening in high-risk populations, including hematology and severely burned patients, shortens diagnostic delays and improves outcomes.

SUMMARY: Compared with conventional methods, Mucorales qPCR provides a rapid, noninvasive, and sensitive diagnostic tool. Large studies have shown that it enables earlier detection, facilitates timely antifungal treatment, and is associated with improved survival.