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Combined use of Random Amplified Polymorphic DNA (RAPD) and touchdown Polymerase Chain Reaction (PCR) for Aspergillus fumigatus epidemiologic studies
Uso combinado de amplificacion aleatoria de polimorfismo del ADN (RAPD) y reacción en cadena de la polimerasa (touchdown PCR) en el estudio epidemiológico de Aspergillus fumigatus
Mercedes Treviño-Castellanoa, Sonia Rodríguez-Novoaa, José Llovo-Taboadaa, Ángeles García-Zabartea, Carlos García-Riestraa, Benito José Regueiro-Garcíaa
a Servicio de Microbiología. Complejo Hospitalario Universitario de Santiago de Compostela (CHUS). A Coruña. España.
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    "textoCompleto" => "<p class="elsevierStylePara">Introduction</p><p class="elsevierStylePara"><span class="elsevierStyleItalic">Aspergillus fumigatus</span>&#44; a filamentous fungus which causes several pulmonary conditions such as allergic bronchopulmonary aspergillosis&#44; aspergilloma and invasive aspergillosis&#44; has emerged as a major problem in immunosupressed patients<span class="elsevierStyleSup">1</span>&#46; Nosocomial outbreaks of aspergillosis are being more frequent&#44; and identification of the isolates may be delayed because of waiting for diagnostically appropiate structures&#46; Furthermore&#44; inexperience in microscopy may lead to misidentification&#46;</p><p class="elsevierStylePara">Randomly amplified polymorphic DNA &#40;RAPD&#41; analysis assays DNA sequence variation in short regions using one short primer and a low annealing temperature to generate several fragments in one amplification reaction<span class="elsevierStyleSup">2</span>&#46; Moreover&#44; RAPD analysis is technically simple and often detects variation among isolates that are invariant with Restriction Fragment Length Polymorphism &#40;RFLP&#41; analysis<span class="elsevierStyleSup">3&#44;4</span>&#46; However&#44; this method is gradually being abandoned because of poor reproducibility<span class="elsevierStyleSup">5</span>&#46; Recently&#44; Ellinghaus et al&#46; have communicated increased efficiency and reproducibility of arbitrarily primed PCR by prolonging ramp times<span class="elsevierStyleSup">6</span>&#46;</p><p class="elsevierStylePara">Otherwise&#44; touchdown PCR with Z19-276 and Z19-660 primers described by Brandt et al&#46;<span class="elsevierStyleSup">7</span> is a useful tool in molecular identification of <span class="elsevierStyleItalic"> Aspergillus fumigatus</span>&#46; This shortens the time&#44; substantially&#44; needed for fungal identification&#46;</p><p class="elsevierStylePara">The present report describes the use of RAPD analysis as a reproducible genotyping method for <span class="elsevierStyleItalic">A&#46; fumigatus</span>&#46;</p><p class="elsevierStylePara">Methods</p><p class="elsevierStylePara">A total of 16 fungal strains isolated from the clinical and hospital environment were tested in this study&#46; American Type Culture Collection &#40;ATCC&#41; 13073 <span class="elsevierStyleItalic">A&#46; fumigatus</span> and ATCC 1004 <span class="elsevierStyleItalic">A&#46; niger</span> were used as positive and negative control&#44; respectively&#46; Isolates were stored at &#173;70 <span class="elsevierStyleSup">o</span>C in brain heart infusion broth containing 10&#37; glycerol&#46; Working stocks were mantained on Sabouraud agar medium at 4 <span class="elsevierStyleSup">o</span>C&#44; and species identifications were made on the basis of standard morphological features<span class="elsevierStyleSup">8</span>&#46;</p><p class="elsevierStylePara">DNA extraction</p><p class="elsevierStylePara">DNA was extracted by a rapid small-scale method that allows several samples to be processed simultaneously&#46; Briefly&#44; a Sabouraud-dextrose agar in a petri dish was inoculated with conidia and incubated at 37<span class="elsevierStyleSup">o</span>C during 24 to 48h&#46; Mycelial growth was peeled off from the agar surface with a sterile scalpel and transferred to a 1&#46;5 ml polypropylene screw-cap tube containing six glass beads&#46; The tube was immersed in liquid nitrogen for 10 s and vortexed vigorously for 30s&#46; Then ground fungal tissue was processed by E&#46;Z&#46;N&#46;A&#46; system &#40;a purifying-column based method&#41; &#40;Omega Biotek&#44; USA&#41; according to the manufacturer&#180;s instructions&#46; The DNA concentrations were estimated spectrophotometrically&#46;</p><p class="elsevierStylePara">Touchdown PCR</p><p class="elsevierStylePara">It was performed in a model 9600 DNA thermal cycler &#40;Perkin-Elmer Corp&#46;&#44; Applied Biosystems&#41;&#46; PCR core reagents and polymerase were purchased from Perkin-Elmer&#46; PCR reaction and amplification conditions were made as previously described<span class="elsevierStyleSup">7</span>&#46; Two primers were chosen to amplify the 864-bp <span class="elsevierStyleItalic">A&#46; fumigatus</span>-specific fragment&#58; primer Z19-276 &#40;5&#39;-TTGATCTGGCCCTGGCTTGGG&#41; and primer Z19-660 &#40;5&#39;-CAACATTGAAATCCAAGAGGC&#41;&#46; Amplification reactions were made in 50 &#181; L volumes containing 1 x PCR buffer &#40;Perkin-Elmer&#41;&#44; 2&#46;5 mM MgCl<span class="elsevierStyleInf">2</span>&#44; 0&#46;2 mM each deoxinucleotide triphosphate&#44; 10 pmol each primer&#44; 1 U AmpliTaq and 50 ng DNA&#46; Amplification protocol was&#58; 31 cycles of 1 minute at 94 &#186;C for denaturation&#44; 1 minute at 65 &#186;C for the three begining cycles and&#44; after&#44; it was decreasing one grade each three cycles&#44; and two grades from 59 &#186;C to 55 &#186;C&#44; temperature used to perform the last 10 cycles&#46; All cycles were finished with 1 minute at 72 &#186;C for elongation&#46;</p><p class="elsevierStylePara">RAPD analysis</p><p class="elsevierStylePara">DNA typing by RAPD was assayed with two oligonucleotide primers&#44; OPZ19 &#40;5&#39;-GTGCGAGCAA&#41; and R108 &#40;5&#39;-GTATTGCCCT&#41;&#46; Amplification reactions were made in 50 &#181; L volumes containing 50 mM KCl&#44; 10 mM Tris-Cl &#40;pH 8&#46;0&#41;&#59; 1&#46;5 mM MgCl<span class="elsevierStyleInf">2</span>&#59; 100 &#181;M each dATP&#44; dCTP&#44; dTTP&#44; and dGTP &#40;Perkin-Elmer&#41;&#44; 0&#46;2 &#181;M each primer&#63;&#59; 50 ng of genomic DNA&#59; and 2&#46;5 U of Taq polymerase &#40;Perkin-Elmer&#41;&#46; Amplifications were carried out by two different protocols&#46; The first one at 1 cycle of 5 minutes at 95 <span class="elsevierStyleSup">o</span>C to denature followed by 45 cycles of 1 minute at 95 <span class="elsevierStyleSup">o</span>C&#44; 1 minute at 34 <span class="elsevierStyleSup">o</span>C and 2 minutes at 72 <span class="elsevierStyleSup">o</span>C &#40;temperature&#47;time rate as minimal as possible&#41; and&#44; finally&#44; 10-minutes final extension at 72 <span class="elsevierStyleSup"> o</span>C&#46; The second one was performed prolonging ramp times drastically between annealing and extension temperatures&#44; 5 and 7 minutes&#44; respectively&#46; Amplification products were fractionated by electrophoresis through 1&#46;8&#37; agarose NuSieve 3&#58;1 &#40;FMC Bioproducts&#44; USA&#41; gels run in 0&#46;5x Tris-borate-EDTA in the presence of ethidium bromide &#40;0&#46;5 mg&#47;ml&#41;&#44; photographed and analyzed&#46; Lanes corresponding to the same sample in different runs were compared by superimposing their intensity profiles &#40;the Rf values in X axis and the pixel intensity values in Y axis&#41; using Quantity one vs&#46; 4&#46;0 software &#40;Bio-Rad&#44; USA&#41;&#46; Afterwards&#44; the similarity coefficient &#40;S&#41; was calculated according to S&#61; 2 N<span class="elsevierStyleInf">AB</span>&#47; N<span class="elsevierStyleInf">A</span> &#43; N<span class="elsevierStyleInf">B</span><span class="elsevierStyleSup">2</span></p><p class="elsevierStylePara">Results</p><p class="elsevierStylePara">Phenotypical identification of the fungal strains</p><p class="elsevierStylePara">A total of 16 fungal strains were isolated by culture techniques&#46; Four <span class="elsevierStyleItalic">A&#46; fumigatus</span> strains &#40;strains number 1&#44; 2&#44; 3&#44; 5&#41; and 1 <span class="elsevierStyleItalic">A&#46; niger</span> strain from clinical source&#46; The following strains were recovered from the hospital environment&#58; 5 <span class="elsevierStyleItalic">A&#46; fumigatus</span> &#40;strains number 7&#44; 8&#44; 9&#44; 11&#44; 13&#41;&#44; 2 <span class="elsevierStyleItalic">A&#46; niger</span> &#40;strains number 14&#44; 16&#41;&#44; 1 <span class="elsevierStyleItalic">Emericella quadrilineata</span> &#40;strains number 10&#41;&#44; 1 <span class="elsevierStyleItalic">Emericella nidulans</span> &#40;strain number 15&#41;&#44; 1 <span class="elsevierStyleItalic">Neosartorya pseudofischeri</span> &#40;strain number 4&#41; and 1 <span class="elsevierStyleItalic">Eurotium repens</span> &#40;strain number 17&#41;&#46;</p><p class="elsevierStylePara">Touchdown PCR</p><p class="elsevierStylePara">A 864 bp amplification product was obtained with the touchdown PCR protocol using Z19-276&#47;Z19-660 primer pair from fungal strains number 1&#44; 2&#44; 3&#44; 5&#44; 7&#44; 8&#44; 9&#44; 11&#44; 13&#44; and <span class="elsevierStyleItalic">A&#46; fumigatus</span> from ATCC according&#44; exactly&#44; to the strains identified as <span class="elsevierStyleItalic">A&#46; fumigatus</span> by phenotypical methods&#46; No amplification band was obtained for the other strains which were morphologically classified as other different species than <span class="elsevierStyleItalic">A&#46; fumigatus</span> &#40;figure 1&#41;&#46;</p><p class="elsevierStylePara"><img src="28v21n9-13052758tab01.gif"></img></p><p class="elsevierStylePara"><span class="elsevierStyleBold">Figure 1&#46;</span> DNA from clinical and environmental fungal isolates amplified with primers Z19-276 and Z19-660 by touchdown protocol&#46; Lanes&#58; <span class="elsevierStyleBold">1</span>&#44; PCR marker &#40;base pair&#41;&#59; <span class="elsevierStyleBold">2&#44; 3&#44; 4&#44; 6&#58;</span><span class="elsevierStyleItalic">A&#46; fumigatus</span> from clinical samples &#40;strains n&#186; 1&#44; 2&#44; 3&#44; 5&#41;&#59; <span class="elsevierStyleBold">8&#44; 9&#44; 10&#44; 12&#44; 14&#58;</span><span class="elsevierStyleItalic">A&#46; fumigatus</span> from environmental samples &#40;strains n&#186; 7&#44; 8&#44; 9&#44; 11&#44; 13&#41;&#59; <span class="elsevierStyleBold">11</span>&#58; <span class="elsevierStyleItalic">E&#46; quadrilineata</span> &#40;strain n&#186; 10&#41;&#44; <span class="elsevierStyleBold">13</span>&#58; <span class="elsevierStyleItalic">A&#46; niger</span>&#44; &#40;ATCC1004&#41; &#40;strain n&#186; 12&#41;&#59; <span class="elsevierStyleBold">15&#44; 17&#58;</span><span class="elsevierStyleItalic">A&#46; niger</span> de origen ambiental &#40;cepas n&#186; 14&#44; 16&#41;&#59; <span class="elsevierStyleBold">16&#58;</span><span class="elsevierStyleItalic">E&#46; nidulans</span> &#40;cepa n&#186; 15&#41;&#59; <span class="elsevierStyleBold">18</span>&#58; <span class="elsevierStyleItalic">E&#46; repens</span> &#40;cepa n&#186; 17&#41;&#59; <span class="elsevierStyleBold">19&#58;</span><span class="elsevierStyleItalic">A&#46; fumigatus</span> from ATCC&#46;</p><p class="elsevierStylePara">RAPD analysis</p><p class="elsevierStylePara">DNAs from a set of isolates comprising clinical and environmental <span class="elsevierStyleItalic">A&#46; fumigatus</span> strains were screened with OPZ19 and R108 primers&#46; The most discriminatory power was obtained for R108 primer which rendered six different types of patterns of bands &#40;figure 2&#41;&#46; The reproducibility and number of bands in RAPD analysis with R108 primer increased prolonging ramp times &#40;table 1&#44; figure 3&#41;&#46; On the contrary&#44; RAPD with OPZ19 primer had an acceptable reproducibility but very little resolution showing two different pattern of bands only&#44; at any of the tested assay conditions &#40;figure 4&#41;&#46;</p><p class="elsevierStylePara"><img src="28v21n9-13052758tab02.gif"></img></p><p class="elsevierStylePara"><img src="28v21n9-13052758tab03.gif"></img></p><p class="elsevierStylePara"><img src="28v21n9-13052758tab04.gif"></img></p><p class="elsevierStylePara"><span class="elsevierStyleBold">Figure 2&#46;</span> RAPD patterns produced with R108 primer&#46; A&#58; Ramp time &#61; 0 minutes&#46; Lanes&#58; <span class="elsevierStyleBold">1</span>&#58; PCR marker &#40;base pair&#41;&#44; lanes <span class="elsevierStyleBold">2-10&#58;</span><span class="elsevierStyleItalic">A&#46; fumigatus</span> &#40;strains n&#186; 1&#44; 2&#44; 3&#44; 5&#44; 7&#44; 8&#44; 9&#44; 11&#44; 13&#41;&#44; <span class="elsevierStyleBold"> 11&#58;</span><span class="elsevierStyleItalic">A&#46; fumigatus</span> from ATCC&#46; B&#58; Ramp time &#61; 5 minutes&#46; Lanes&#58; <span class="elsevierStyleBold">1-9</span>&#58; <span class="elsevierStyleItalic">A&#46; fumigatus</span> &#40;strain n&#186; 1&#44; 2&#44; 3&#44; 5&#44; 7&#44; 8&#44; 9&#44; 11&#44; 13&#41;&#59; <span class="elsevierStyleBold">10<span class="elsevierStyleItalic">&#58;</span></span><span class="elsevierStyleItalic">A&#46; fumigatus</span> from ATCC&#59; <span class="elsevierStyleBold">11&#58;</span> Size marker &#40;bp&#41;&#46; C&#58; Ramp time &#61; 7 minutes&#46; Lanes distribution as in figure 2 A&#46;</p><p class="elsevierStylePara"><img src="28v21n9-13052758tab05.gif"></img></p><p class="elsevierStylePara"><img src="28v21n9-13052758tab06.gif"></img></p><p class="elsevierStylePara"><span class="elsevierStyleBold">Figure 3&#46;</span> Patterns of bands obtained in different runs with different DNA extractions&#46; A and B&#58; Two different runs using the first DNA extraction&#46; Figures C and D&#58; Two different runs using the second DNA extraction&#46; Lanes&#58; <span class="elsevierStyleBold">1&#58;</span> Size marker&#59; <span class="elsevierStyleBold">2-10&#58;</span><span class="elsevierStyleItalic">A&#46; fumigatus</span> &#40;strain n&#186; 1&#44; 2&#44; 3&#44; 5&#44; 7&#44; 8&#44; 9&#44; 11&#44; 13&#41;&#44; <span class="elsevierStyleBold"> 11&#58;</span><span class="elsevierStyleItalic">A&#46; fumigatus</span> from ATCC&#46;</p><p class="elsevierStylePara"><img src="28v21n9-13052758tab07.gif"></img></p><p class="elsevierStylePara"><span class="elsevierStyleBold">Figure 4&#46;</span> DNA from <span class="elsevierStyleItalic">A&#46; fumigatus</span> strains amplified by RAPD-PCR using the OPZ-19 primer&#46; Lanes&#58; <span class="elsevierStyleBold">1&#58;</span> PCR marker &#40;bp&#41;&#59; <span class="elsevierStyleBold">2-10&#58;</span><span class="elsevierStyleItalic">A&#46; fumigatus</span> &#40;strains number 1&#44; 2&#44; 3&#44; 5&#44; 7&#44; 8&#44; 9&#44; 11&#44; 13&#41;&#59; 11&#58; <span class="elsevierStyleItalic"> A&#46; fumigatus</span> from ATCC&#46;</p><p class="elsevierStylePara">Discussion</p><p class="elsevierStylePara">By using touchdown annealing conditions&#44; the Z19-276&#47;660 primer-probe combination successfully amplified and detected DNAs from all the strains that were morphologically identified as <span class="elsevierStyleItalic">A&#46; fumigatus&#46;</span> So&#44; this result confirms the great utility for accurate and timely identification of <span class="elsevierStyleItalic">A&#46; fumigatus</span> from clinical and environmental samples&#46; This detection is extremily important for the diagnosis and management of the diseases as well as for surveillance and epidemiologic studies&#46; However&#44; some uncommon varieties <span class="elsevierStyleItalic">as A&#46; fumigatus var&#46; sclerotium</span> and non pigmented strains may show faint or no reactivity under these conditions<span class="elsevierStyleSup">7</span>&#46;</p><p class="elsevierStylePara">Among several techniques that have been applied successfully to study fungal epidemiology&#44; RAPD analysis is the most technically simple and often detects variation between isolates that are invariant with RFLP analysis<span class="elsevierStyleSup">10-12</span>&#46; However&#44; its poor reproducibility has been considered to be a serious disadvantage&#46; R108&#44; a primer used successfully in RAPD analysis of <span class="elsevierStyleItalic">A&#46; fumigatus</span> by other authors<span class="elsevierStyleSup">4&#44;13</span>&#44; demonstrated a high discriminatory power&#44; which is consistent with the results obtained by other authors<span class="elsevierStyleSup">4&#44;14</span>&#46; Only two clinical strains were not distinguished by R108 protocol&#46; These ones were from patients who stayed at the same operating theater and postsurgery care floor&#44; at the same time&#46; Therefore&#44; they were&#44; probably&#44; infected by the same strain&#46;</p><p class="elsevierStylePara">Although it is advisable that RAPD analysis be made with several primers&#44; the use&#44; only&#44; of one of them with high discriminatory power&#44; may be enough to manage the outbreak&#44; avoiding more assays money and time-consuming<span class="elsevierStyleSup">15</span>&#46; In our study&#44; prolonged ramp times between the annealing and the extension temperatures lead to an important increase in reproducibility of the patterns of bands obtained with R108 primer&#44; according to the results obtained by P&#46; Ellinghaus et al&#46; with <span class="elsevierStyleItalic">Candida sp&#46;</span> genome<span class="elsevierStyleSup">6</span>&#46; Also&#44; the number&#44; yield and reproducibility of the DNA fingerprint obtained was improved&#44; significantly&#46; A potential mechanism might be that the lower heating rates stabilize the primer&#47;template complexes by avoiding premature detachment of the primer from the template&#46; Otherwise&#44; RAPD with OPZ19&#44; a primer reactive with all strains of <span class="elsevierStyleItalic">A&#46; fumigatus</span>&#44; except non pigmented variants&#44; had acceptable repetitivity with all the ramp times assayed&#44; perhaps related with their own sequence because it is known that reproducibility and intensity of the bands in a fingerprint should be a function of several parameters including primer length and primer sequence<span class="elsevierStyleSup">16</span>&#46; However&#44; prolonged ramp times reported an increase in number and yield of the DNA bands obtained&#46;</p><p class="elsevierStylePara">In conclusion&#44; RAPD analysis is a truly rapid and reliable tool in DNA fingerprinting&#46; Patterns may be easier to repeat and interpret when drastically prolonged ramp times between annealing and extension are used&#46; Combining touchdown PCR and RAPD analysis is a sensible and accurate method for epidemiologic studies of clinical outbreaks of <span class="elsevierStyleItalic">A&#46; fumigatus</span> making use of the habitual techniques available in a current clinical microbiology laboratory&#46;</p><p class="elsevierStylePara"> Acknowledgments</p><p class="elsevierStylePara">We thank A&#46;M&#46; Commons for translation review of the manuscript&#46;</p>"
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            0 => "Aspergillus fumigatus"
            1 => "RAPD"
            2 => "Touchdown PCR"
            3 => "Aspergillus fingerprint"
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            0 => "Aspergillus fumigatus"
            1 => "RAPD"
            2 => "Touchdown PCR"
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        "resumen" => "Introduction&#46; Aspergillus fumigatus is a filamentous fungus that acts as an opportunistic pathogen and has emerged as a major problem in immunosuppressed patients&#46; Nosocomial outbreaks of aspergillosis are becoming more frequent&#44; but their identification and epidemiological characterization is slow and difficult&#46; Objective&#46; Description of a fast&#44; sensitive&#44; specific method to identify and fingerprint A&#46; fumigatus using methodology available in clinical laboratories&#46; Methods&#46; We studied several strains of A&#46; fumigatus isolated from patients with invasive aspergillosis &#40;n 5 4&#41;&#44; the hospital environment &#40;n 5 5&#41; and reference cultures &#40;n 5 1&#41;&#44; as well as other close phylogenetic fungal species from patients &#40;n 5 1&#41;&#44; hospital environment &#40;n 5 6&#41; and reference cultures &#40;n 5 1&#41;&#46; A&#46; fumigatus was identified by both touchdown PCR and conventional phenotyping methods&#46; Genotyping was performed with random amplification of polymorphic DNA &#40;RAPD&#41; analysis&#44; comparing the results from two primers &#40;OPZ-19 and R-108&#41; and different amplification protocols with regard to band resolution and reproducibility&#46; Results&#46; Touchdown PCR and phenotype results were identical&#46; Best RAPD results were obtained with the R-108 primer and considerably longer ramp times between annealing and extension&#46; Conclusion&#46; RAPD analysis is a fast&#44; reliable tool for DNA fingerprinting&#46; Patterns may be easier to repeat and interpret when longer ramp times are used&#46; Touchdown PCR combined with RAPD analysis is a sensitive&#44; accurate method for managing clinical outbreaks of Aspergillus fumigatus&#46;"
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        "resumen" => "Introducci&#243;n&#46; Aspergillus fumigatus es un hongo filamentoso que se comporta como pat&#243;geno oportunista y constituye una de las complicaciones infecciosas m&#225;s importantes en los pacientes inmunocomprometidos&#46; Los brotes nosocomiales de aspergilosis son cada vez m&#225;s frecuentes&#44; pero su identificaci&#243;n y caracterizaci&#243;n epidemiol&#243;gica es lenta y laboriosa&#46; Objetivo&#46; Describir un m&#233;todo r&#225;pido&#44; sensible y espec&#237;fico para la identificaci&#243;n de A&#46; fumigatus y su caracterizaci&#243;n genot&#237;pica dentro de las posibilidades diagn&#243;sticas habituales en un laboratorio cl&#237;nico de microbiolog&#237;a&#46; M&#233;todos&#46; Se utilizaron cepas de A&#46; fumigatus procedentes de pacientes con aspergilosis invasivas &#40;n 5 4&#41;&#44; medio ambiente hospitalario &#40;n 5 5&#41; y colecciones de referencia &#40;n 5 1&#41;&#44; as&#237; como otras especies f&#250;ngicas filogen&#233;ticamente pr&#243;ximas aisladas de pacientes &#40;n 5 1&#41;&#44; del medio hospitalario &#40;n 5 6&#41; o de colecciones de referencia &#40;n 5 1&#41;&#46; La identificaci&#243;n de A&#46; fumigatus se realiz&#243; tanto por m&#233;todos fenot&#237;picos cl&#225;sicos como mediante touchdown PCR &#40;reacci&#243;n en cadena de la polimerasa&#41;&#46; La caracterizaci&#243;n genot&#237;pica se llev&#243; a cabo por RAPD &#40;polimorfismo derivado de la amplificaci&#243;n aleatoria de ADN&#41;&#44; comparando distintos protocolos de amplificaci&#243;n y tipos de primer &#40;OPZ-19 y R-108&#41; en relaci&#243;n con su poder resolutivo y reproducibilidad&#46; Resultados&#46; Los resultados de la identificaci&#243;n fenot&#237;pica y molecular coincidieron plenamente&#46; La caracterizaci&#243;n molecular por RAPD present&#243; los mejores resultados&#44; en cuanto a reproducibilidad y resoluci&#243;n se refiere&#44; con el primer R-108 y tiempo prolongado de transici&#243;n entre hibridaci&#243;n y elongaci&#243;n&#46; Conclusi&#243;n&#46; El an&#225;lisis por RAPD es un m&#233;todo seguro y r&#225;pido para la caracterizaci&#243;n genot&#237;pica de A&#46; fumigatus cuyos patrones de bandas son f&#225;ciles de interpretar y reproducir cuando se prolonga dr&#225;sticamente el tiempo de transici&#243;n entre la hibridaci&#243;n y la extensi&#243;n&#46; El uso combinado de touchdown PCR y an&#225;lisis por RAPD constituye un m&#233;todo sensible y exacto para la resoluci&#243;n de brotes nosocomiales por A&#46; fumigatus&#46;"
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Article information
ISSN: 0213005X
Original language: English
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es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos