Use of the polymerase chain reaction (PCR) for the detection of fungi in human specimens has been practised for almost two decades. Yet the technique was not included in the initial or revised European Organisation for Research and Treatment of Cancer and the Mycoses Study Group (EORTC/MSG) consensus definitions for diagnosing invasive fungal diseases (IFD) due to limited standardisation. This changed in 2006, when the UK Fungal PCR Consensus group published an agreed methodology for PCR aided diagnosis of IA within the UK and Ireland. Then, at the meeting of the International Society for Human and Animal Mycoses (ISHAM) in Paris in September 2006, a group of experts founded the European Aspergillus PCR Initiative (EAPCRI), eventually involving more than 60 centres across Europe, Australia, USA and the Middle East.
The EAPCRI agreed to collaborate to develop a standard for Aspergillus PCR methodology and to validate this in clinical trials so that PCR could be incorporated into future consensus definitions for diagnosing IFD.The EAPCRI consists of a laboratory, clinical and statistical working party with a steering committee charged with focusing the overall direction of the group, providing a link between the working parties and raising the necessary funds. The extensive efforts of the EAPCRI in standardizing Aspergillus PCR methodology have been well described through multiple publications, leading to the proposal for Aspergillus PCR to be included inthe second revision of the EORTC/MSG consensus definitions.
Given the success of the efforts to standardize Aspergillus PCR, it was decided that molecular techniques to aid in the diagnosis of other IFD would be beneficial. To reflect this increase in remit, but also the global nature of these efforts, the Fungal PCR initiaive was borne, with the aim of evaluating and standardizing PCR testing of Candida, Pneumocystis, Mucorales species and fungal infection specifically within tissue, while also progressing on the existing work of the Aspergillus group. The overall structure of each specific PCR working group remains a partnership between clinical and laboratory working parties, each supported by the statistical working party, with the overall direction still maintained by the steering committee. It is hoped that the succesful efforts associated with Aspergillus PCR will also be seen within the other groups, and work is progressing at a pace.