Tissue suspected of being infected with Mucorales should be minced into small pieces with a scalpel or single edge razor blade before inoculation onto media; grinding or homogenisation of tissue specimens may destroy the delicate hyphae rendering cultures negative. Colonies of Mucorales usually appear within 24–48 h unless residual antifungal agents, which can suppress growth. Most species demonstrate a greyish white, aerial mycelium with a wooly texture and fill a culture dish within 3–5 days. This study will therefore utilise morphological, physiological

and molecular methods for identification of organisms in culture and, where feasible, in paraffin-embedded tissue. Development of an archive of organisms recovered from patients with documented mucormycosis Sorafenib clinical trial is essential selleck kinase inhibitor to achieving objective III. There are now several molecular and antigenic assays that detect the presence of Mucorales in laboratory animal models of mucormycosis.[14, 15] Other systems have not been studied in animal model systems but also exhibit analytical sensitivity and specificity

for the Mucorales.[16-19] Although one report describes the analytical performance of a three quantitative polymerase chain reaction assays using hydro-lysis mafosfamide probes in 10 patients, the small number of cases and complexity of the molecular diagnostic platform limit regulatory review or extrapolation to other laboratories.[20] To enable candidate assays to become widely available for early diagnosis of mucormycosis and to improve patient outcome, an archive of specimens for

mucormycosis is critically required. As these assays must be validated in human specimens of mucormycosis for scientific, clinical and regulatory acceptance, the development of this archive (IMAS) is critical. This specimen archive will consist of the clinical samples (Table 3), where feasible and applicable, from each patient enrolled into ZWG2. Each investigator will store the specimens at his or her centre. At a designated time, specimens will be divided in equal amounts by the investigator and shipped to two central facilities under the care of Dr. Olivier Lortholary at the ZWG Archive Center in Paris and Dr. Thomas Walsh at the ZWG Archive Center in New York City. Storage in two geographically distinct locations assures preservation of specimens in the event of natural or human-made disasters. Following review of candidate assays, specimens will then be shipped to investigators conducting laboratory diagnostic projects approved by the ZWG Steering Committee.