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Investigation
Development of new diagnostic methods for invasive fungal infection
Research Lines
Content with Investigacion .
El diagnóstico de la infección fúngica invasora (IFI) es complicado y con frecuencia se retrasa ya que en muchas ocasiones a la falta de sospecha clínica se le suma la falta de herramientas diagnósticas eficaces. Esta línea de investigación se inició en el año 2003, primero liderada por el Dr. Manuel Cuenca-Estrella y posteriormente por la Dra. María José Buitrago con el objetivo general de desarrollar nuevas herramientas, basadas en la PCR en tiempo Real, para un diagnóstico rápido de IFI. Los objetivos concretos que se han ido alcanzando a lo largo de estos años han sido los siguientes:
Detección precoz de hongos causantes de infecciones fúngicas oportunistas más frecuentes en pacientes inmunodeprimidos (Aspergilosis y Candidiasis invasoras)
Se han desarrollado y validado técnicas de PCR en tiempo Real en formato multiplex para el cribado de pacientes en riesgo de padecer estas infecciones, así como para el diagnóstico en pacientes con sospecha.
Detección de IFIs causadas por hongos emergentes (Escedosporiosis, Fusariosis etc...)
El aumento de especies raras o poco frecuentes causantes de IFI hizo necesario el desarrollo de técnicas para su detección
Detección “panfúngica”
Para aquellos casos en los que no exista evidencia clara del hongo causante de la infección se han desarrollado técnicas basadas en PCR en tiempo Real.
Mejora del diagnóstico y la identificación de los hongos causantes de micosis importadas (micosis endémicas)
Debido al aumento de la inmigración y los viajes a lugares exóticos en los últimos años se ha producido un incremento de las micosis importadas en España, en concreto de aquellas causadas por hongos endémicos de determinadas regiones, los cuales son además patógenos primarios. Este objetivo es relevante en el contexto de una región no-endémica ya que existe falta de experiencia en el manejo de estas infecciones y las técnicas diagnósticas disponibles son muy escasas. A lo largo de estos años se han desarrollado y validado distintas técnicas para el diagnóstico rápido de estas micosis y se han realizado diferentes trabajos encaminados a un mejor conocimiento de los hongos que las causan.
Las técnicas desarrolladas a lo largo de estos años se han incorporado a la Cartera de Servicios del Centro Nacional de Microbiología para ofrecerlas al Sistema Nacional de Salud. Además, algunas de ellas se han patentado.
Research projects
Content with Investigacion .
1. Nombre del proyecto: Mejora del pronóstico del paciente con riesgo de enfermedad fúngica invasora: estudio de susceptibilidad del huésped y desarrollo de nuevos métodos de diagnóstico clínico. Entidad/es financiadora/s: Instituto de Salud Carlos III. Fecha de inicio-fin: 01/01/2018 - 31/12/2020. Cuantía: 72.000 €. Investigadores principales (IP, Co-IP,...): María José Buitrago Serna/Laura Alcazar Fuoli
2. Nombre del proyecto: Red española de Investigación en Patologías infecciosas REIPI
Entidad/es financiadora/s: ISCIII-FEDER Fecha de inicio-fin: 01/01/2017 - 31/12/2021
Cuantía total: 195.612 €. Coordinador: Emilia Mellado
3. Nombre del proyecto: Desarrollo y validación de un método de detección de tipo “point of care”. Entidad/es financiadora/s: Instituto de Salud Carlos III. Fecha de inicio-fin: 01/01/2015 - 31/12/2017. Cuantía total: 46.000 €. Investigador principal: María José Buitrago.
4. Nombre del proyecto: European Research Infrastructure on Highly Pathogenic Agents 2-ERINHA2(Horizon2020). Nombre del programa: FP7-Infraestructuras-2015. Programa marco. THEME (INFRA-2010-2.2.8: High Security BLS4 Laboratory). Entidad financiadora: Unión Europea. Fecha de inicio-fin: 01/01/2016 - 01/06/2017. Cuantía total: 524.848 €. Cuantía subproyecto: 141.562 €. Coordinador (IP): Raoul Hervé.
5. Nombre del proyecto: Iberian network of laboratories of Biological Alert Acreditation of methods for detection of highly pathogenic agents/IB-BiOALERNET Entidad/es financiadora/s: DG-Home (Unión Europea). Fecha de inicio-fin: 2013 – 2015. Cuantía total: 629.382,67 €. Coordinador (IP): Carmen Cañavate
6. Nombre del proyecto: Desarrollo de nuevos métodos de diagnóstico e identificación de especies fúngicas causantes de neumonías oportunistas. Entidad/es financiadora/s: ISCIII. Fecha de inicio-fin: 2012 – 2015. Cuantía total: 67.429,67 €. Investigador principal: María José Buitrago.
7. Nombre del proyecto: European Research Infrastructure on Highly Pathogenic Agents 2-ERINHA2 (Horizon2020). Nombre del programa: FP7-Infraestructuras-2015. Programa marco. THEME (INFRA-2010-2.2.8: High Security BLS4 Laboratory. Entidad financiadora: Unión Europea. Fecha de inicio-fin: 01/01/2010 - 31/12/2013. Cuantía total: 4.859.782,5 €. Coordinador (IP): Raoul Hervé.
8. Nombre del proyecto: RED iberoamericana de diagnóstico molecular de las infecciones endémicas y oportunistas. Entidad/es financiadora/s: CYTED-AECI. Fecha de inicio-fin: 2008 – 2009. Cuantía total: 70.000 €. Investigador principal: Luz-Elena Cano
9. Nombre del proyecto: “Desarrollo de nuevos métodos de diagnóstico en alertas biosanitarias relacionadas con la Micología”. Entidad/es financiadora/s: Instituto de Salud Carlos III. Fecha de inicio-fin: 2007 – 2009. Cuantía total: 58.500 €. Investigador Principal: María José Buitrago
Publications
Ribavirin Had Demonstrable Effects on the Crimean-Congo Hemorrhagic Fever Virus (CCHFV) Population and Load in a Patient With CCHF Infection
9. Nicole Espy; Unai Pérez-Sautu; Eva Ramírez de Arellano; Anabel Negredo; MR Wiley; S Bavari; Marta Díaz Manéndez; María Paz Sánchez-Seco; Gustavo Palacios. Ribavirin Had Demonstrable Effects on the Crimean-Congo Hemorrhagic Fever Virus (CCHFV) Population and Load in a Patient With CCHF Infection. J Infect Dis. 217 - 12, pp. 1952 - 1956. 25/05/2018.
PUBMED DOIAcute respiratory distress syndrome after convalescent plasma use: treatment of a patient with Ebola virus disease contracted in Madrid, Spain.
10. M Mora-Rillo, M Arsuaga, G Ramírez-Olivencia, F de la Calle, A M Borobia, P Sánchez-Seco, M Lago, J C Figueira, B Fernández-Puntero, A Viejo, A Negredo, C Nuñez, E Flores, A J Carcas, V Jiménez-Yuste, F Lasala, A García-de-Lorenzo, F Arnalich, J R Arribas, for the La Paz-Carlos III University Hospital Isolation Unit. Acute respiratory distress syndrome after convalescent plasma use: treatment of a patient with Ebola virus disease contracted in Madrid, Spain. Lancet Respir Med. 3-7, pp:554-562. 31/05/2015
PUBMED DOIViral infections of the central nervous system in Spain: a prospective study.
1. F. de Ory, A. Avellón, J.E. Echevarría, M.P. Sánchez-Seco, G. Trallero, M. Cabrerizo, I. Casas, F. Pozo, G. Fedele, D. Vicente, M. J. Pena, A. Moreno, J. Niubo, N. Rabella, G. Rubio, M. Pérez Ruiz, M. Rodríguez-Iglesias, C. Gimeno, J.M. Eiros, S. Melón, M. Blasco, I. López-Miragaya, E. Varela, A. Martinez-Sapiña, G. Rodríguez, M.Á. Marcos, M.I. Gegúndez, G. Cilla, I. Gabilondo, J.M. Navarro, J. Torres, C. Aznar, A. Castellanos, M.E. Guisasola, A.I. Negredo, A. Tenorio, S. Vázquez-Morón (2013). Viral Infections of the Central Nervous System in Spain: a prospective Study. JOURNAL OF MEDICAL VIROLOGY 85: 554-562.
PUBMED DOIFirst case of imported Zika virus infection in Spain
4. P. Bachiller-Luque, M. Dominguez-Gil-González, J. Alvarez-Manzanares, A. Vázquez, F. de Ory, M.P. Sánchez-Seco Fariñas (2016). First case of Zika virus infection imported to Spain (original breve). ENFERMEDADES INFECCIOSAS Y MICROBIOLOGÍA CLÍNICA, 34: 243-246.
PUBMED DOIChikungunya virus infections among travellers returning to Spain, 2008 to 2014.
5. M.D. Fernandez-Garcia, M. Bangert, F. de Ory, A. Potente, L. Hernández, F. Lasala, L. Herrero, F. Molero, A. Negredo, A. Vázquez, T. Minguito, P. Balfagón, J. de la Fuente, S. Puente, E. Ramírez de Arellano, M. Lago, M.J. Martinez, J. Gascón, F. Norman, R. Lopez-Velez, E. Sulleiro, D. Pou, N. Serre, R. Fernández-Roblas, A. Tenorio, L. Franco, M.P. Sánchez-Seco (2016). Chikungunya virus infections among travelers returning to Spain, 2008-2014. EUROSURVEILLANCE 2016; 21(36):pii=30336.
PUBMED DOIComparison of commercial methods of immunoblot, ELISA, and chemiluminescent immunoassay for detecting type-specific herpes simplex viruses-1 and -2 IgG.
7. F. de Ory, M.E. Guisasola, P. Balfagón, J.C. Sanz. 2018. Comparison of commercial methods of immunoblot, ELISA, and chemiluminescent immunoassay for detecting type-specific herpes simplex viruses-1 and -2 IgG. JOURNAL OF CLINICAL LABORATORY ANALYSIS; 32:e22203.
PUBMED DOIGenomic non-coding regions reveal hidden patterns of mumps virus circulation in Spain, 2005 to 2015.
8. A.M. Gavilán, A. Fernández-García, A. Rueda, A. Castellanos, J. Masa-Calles, N. López-Perea, M.V. Torres de Mier, F. de Ory, J.E. Echevarría. 2018. Genomic non-coding regions reveal hidden patterns of mumps virus circulation in Spain, 2005 to 2015. EUROSURVEILLANCE, 2018;23(15):pii=17-00349.
PUBMED DOIComparative evaluation of indirect immunofluoresecence and NS-1 based ELISA for the determination of Zika virus specific IgM.
9. F. de Ory, M.P. Sánchez-Seco, A. Vázquez, M.D. Montero, E. Sulleiro, M.J. Martinez, L. Matas, F.J. Merino, and Working Group for the Study of Zika Virus Infections (WGSZVI). 2018. Comparative evaluation of indirect immunofluoresecence and NS-1 based ELISA for the determination of Zika virus specific IgM. VIRUSES 10, 379
PUBMED DOIMeasles virus genotype D4 strains with non-standard genome lengths circulated during the large outbreaks in Spain in 2011-2012
10. H. Gil, A. Fernández-García, M.M. Mosquera, J.M. Hübschen, A. Castellanos, F. de Ory, J. Masa, J.E. Echevarria. 2018. Measles virus genotype D4 strains with non-standard length M-F non-coding region circulated during the major outbreaks of 2011-2012 in Spain. PLOS ONE July 16, 2018.
PUBMED DOIHepatitis E genotype 3 genome: A comprehensive analysis of entropy, motif conservation, relevant mutations, and clade-associated polymorphisms
• Muñoz-Chimeno M, Rodríguez-Paredes V, García-Lugo MA, Avellón A. Hepatitis E genotype 3 genome: A comprehensive analysis of entropy, motif conservation, relevant mutations, and clade-associated polymorphisms. Front Microbiol. 2022 Oct 6;13:1011662.
PUBMED DOIFrecuencia de sustituciones relevantes asociadas a resistencia en la región NS5A a elbasvir en el virus de la hepatitis C en pacientes con genotipo 1a en España
Palladino C, Esteban-Cartelle B, Mate-Cano I, Sánchez-Carrillo M, Resino S, Briz V. Frecuencia de sustituciones relevantes asociadas a resistencia en la región NS5A a elbasvir en el virus de la hepatitis C en pacientes con genotipo 1a en España Enferm Infecc Microbiol Clin. 2018; 36 (5): 262-267
PUBMED DOIProline-Rich Hypervariable Region of Hepatitis E Virus: Arranging the Disorder.
• Muñoz-Chimeno M, Cenalmor A, García-Lugo MA, Hernandez M, David Rodríguez-Lazaro D, Avellón A. Proline-Rich Hypervariable Region of Hepatitis E Virus: Arranging the Disorder. Microorganisms. 2020 Sep 15;8(9):1417.
PUBMED DOIClinical performance of Determine HBsAg 2 rapid test for Hepatitis B detection.
• Avellón A, Ala A, Diaz A, Domingo D, González R, Hidalgo L, Kooner L, Loganathan S, Martin D, McPherson S, Muñoz-Chimeno M, Ryder S, Gabrielle Slapak G, Ryan P, Valbuena M, Kennedy PT. Clinical performance of Determine HBsAg 2 rapid test for Hepatitis B detection. J Med Virol. 2020 Apr 9.
PUBMED DOIHepatitis E virus genotype 3 microbiological surveillance by the Spanish Reference Laboratory: geographic distribution and phylogenetic analysis of subtypes from 2009 to 2019.
• Muñoz-Chimeno M, Bartúren S, García-Lugo MA, Morago L, Rodríguez A, Galán JC, Pérez-Rivilla A, Rodríguez M, Millán R, Del Álamo M, Alonso R, Molina L, Aguinaga A, Avellón A. Hepatitis E virus genotype 3 microbiological surveillance by the Spanish Reference Laboratory: geographic distribution and phylogenetic analysis of subtypes from 2009 to 2019. Euro Surveill. 2022 Jun;27(23):2100542.
PUBMED DOIHepatitis E virus: Assessment of the epidemiological situation in humans in Europe
• Adlhoch C, Avellón A, Baylis SA, Ciccaglione AR, Couturier E, de Sousa R, Epštein J, Ethelberg S, Faber M, Fehér A, Ijaz S, Lange H, Manďáková Z, Mellou K, Mozalevskis A, Rimhanen-Finne R, Rizzi V, Said B, Sundqvist L, Thornton L, Tosti ME, van Pelt W, Aspinall E, Domanovic D, Severi E, Takkinen J, Dalton HR. Hepatitis E virus: Assessment of the epidemiological situation in humans in Europe, 2014/15. J Clin Virol. 2016 Sep;82:9-16.
PUBMED DOIEmergence of linezolid-resistant coagulase-negative staphylococci in an intensive care unit
2. Emergence of linezolid-resistant coagulase-negative staphylococci in an intensive care unit. Balandin B, Lobo B, Orden B, Román F, García E, Martínez R, Valdivia M, Ortega A, Fernández I, Galdos P. Infect Dis (Lond). 2016;48(5):343-9.
PUBMED DOIHorizontal gene transmission of the cfr gene to MRSA and Enterococcus: role of Staphylococcus epidermidis as a reservoir and alternative pathway for the spread of linezolid resistance.
3. Horizontal gene transmission of the cfr gene to MRSA and Enterococcus: role of Staphylococcus epidermidis as a reservoir and alternative pathway for the spread of linezolid resistance. Cafini F, Nguyen le TT, Higashide M, Román F, Prieto J, Morikawa K. J Antimicrob Chemother. 2016 Mar;71(3):587-92.
PUBMED DOIContent with Investigacion .
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Leticia Bernal Martínez
Staff Scientist
ORCID code: 0000-0002-1694-5522
Dr. Bernal-Martínez obtained her degree in Biochemistry from the University of Zaragoza in 2005. She joined the Mycology Reference and Research Laboratory (LRIM) in 2006 under a trainee contract and completed her PhD within the Official Doctoral Program in Microbiology and Parasitology at the Complutense University of Madrid, defending her thesis in 2010 with highest honors (Cum Laude). In 2007, she continued her research activity at LRIM within the framework of the Spanish Network for Research in Infectious Diseases (REIPI). In 2016, she completed a Postgraduate Diploma in Promotion and Management of International Projects (Technical University of Madrid) and undertook a research stay at the Microbiology and Infection Research Domain, Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho (Braga, Portugal). She was subsequently appointed as a PhD researcher within the Biomedical Research Networking Center in Infectious Diseases (CIBERINFEC). Since 2024, she serves as Specialist Scientist at the Carlos III Health Institute (ISCIII) and is responsible for the Diagnostic and Serology Section for Endemic Fungi at the Mycology Reference and Research Laboratory.
Dr. Bernal-Martínez has authored more than 30 peer-reviewed scientific publications and two book chapters. She has actively participated in over 12 research projects and has presented her work at numerous national and international scientific conferences. Her research has focused on human fungal infections, antifungal resistance, therapeutic drug monitoring, genetic variants associated with antifungal metabolism, and the identification of predictive biomarkers of invasive fungal infections. However, her primary expertise lies in the diagnostic field, particularly in the design, optimization, and validation of real-time PCR–based methodologies.
She is currently Principal Investigator of a research project aimed at improving current diagnostic techniques for invasive fungal infections, evaluating emerging diagnostic technologies, and studying primary fungal pathogens. A substantial part of her work has been transferred to the Spanish National Health System and to research centers in Latin America. Many of the diagnostic methodologies developed have been incorporated into the official service portfolio of ISCIII. She has collaborated with multiple hospitals through research projects and clinical trials applying these technologies, as well as with the ISCIII spin-off company Micomol S.L.
Dr. Bernal-Martínez has supervised several Master’s and Undergraduate Final Degree Projects from students at the Complutense University of Madrid and the University of Alcalá. She is a member of the teaching staff of the UNED-ISCIII PhD Program in Biomedical Sciences and Public Health and serves as lecturer in the Master’s Program in Public Health and Research in Infectious Diseases at the University of Alcalá.
List of staff
Additional Information
RECENT COLLABORATIONS
1. Dr. Marco Teixeira. Visiting professor at the University of Brasilia (UnB). Affiliated researcher at Northern Arizona University (NAU)
2. Dr. Alexandre Alanio. Researcher at Hôpital St. Louis, Paris. France
3. Dr. Dunja Wilmes. Researcher at the Robert Koch Institute. Sedan. Germany.
4. Dr. Paula Sampaio. Center for Molecular and Environmental Biology (CBMA), Department of Biology, University of Minho, Braga, Portugal
5. Dr. Rosely Zancope-Oliveira. Professor at the Oswaldo Cruz Foundation. Rio de Janeiro, Brazil.
6. Dr. Ana Cecilia Mesa Arango. Professor at the University of Antioquia. Medellin. Colombia
7. Dr. Néstor Pakasa. Professor, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo
8. Dr. David aka. Researcher at the Félix Houphouët-Boigny University, Abidjan, Ivory Coast
PATENTS
a) Registered industrial property title: “Development of a rapid method for the diagnosis of histoplasmosis and/or paracoccidioidomycosis by multiplex Real-Time PCR with Molecular Beacon type probe initiators.” Inventors: María José Buitrago Serna; Manuel Cuenca Estrella; Juan Luis RodriguezTudela; Alicia Gómez López. Rights holder entity: Carlos III Health Institute. Application number: P200802665. Country of registration: Spain. Registration date: 09/19/2008. Grant date: 09/14/2011
b) Registered industrial property title: Riboflavin-synthese in Ashbya gossypii. Inventors/authors/breeders: Jose Luis Revuelta Doval; María José Buitrago Serna; Maria de los Angeles Santos García. Rights holder entity: BASF Aktiengesellschaft. Application number: CA 2186403. Registration date: 03/25/1994. Grant date: 01/24/2006
c) Registered industrial property title: Riboflavin-Synthese in Hefen. Inventors/authors/breeders: Jose Luis Revuelta Doval; Jose Javier García Ramírez; Maria de Los Angeles Santos García; Gloria Angélica González; María José Buitrago Serna. Rights holder entity: BASF Aktiengesellschaft. Application number: EP19940901793. Registration date: 11/19/199. Grant date: 05/07/1997
DIRECTION OF DOCTORAL THESES
1. Title: Development of new methods for diagnosis and identification of fungal species that cause opportunistic pneumonia. Implementation entity: Complutense University-ISCIII. Student: Clara Valero Fernández. Qualification obtained: Excellent Cum Laude. Defense date: 05/19/2017
2. Title: Development and Validation of diagnostic techniques for invasive fungal infection. Implementation entity: Complutense University of Madrid-ISCIII. Student: Sara Gago Prieto. Grade obtained: Excellent cum laude. Defense date: 07/18/2014
3. Title: Development of techniques based on real-time PCR for the diagnosis of invasive fungal infections. Implementation entity: Complutense University of
Madrid-ISCIII. Student: Leticia Bernal Martinez. Grade obtained: Excellent cum laude. Defense date: 2010
RECENT COLLABORATIONS
1. Dr. Marco Teixeira. Visiting professor at the University of Brasilia (UnB). Affiliated researcher at Northern Arizona University (NAU)
2. Dr. Alexandre Alanio. Researcher at Hôpital St. Louis, Paris. France
3. Dr. Dunja Wilmes. Researcher at the Robert Koch Institute. Sedan. Germany.
4. Dr. Paula Sampaio. Center for Molecular and Environmental Biology (CBMA), Department of Biology, University of Minho, Braga, Portugal
5. Dr. Rosely Zancope-Oliveira. Professor at the Oswaldo Cruz Foundation. Rio de Janeiro, Brazil.
6. Dr. Ana Cecilia Mesa Arango. Professor at the University of Antioquia. Medellin. Colombia
7. Dr. Néstor Pakasa. Professor, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo
8. Dr. David aka. Researcher at the Félix Houphouët-Boigny University, Abidjan, Ivory Coast
PATENTS
a) Registered industrial property title: “Development of a rapid method for the diagnosis of histoplasmosis and/or paracoccidioidomycosis by multiplex Real-Time PCR with Molecular Beacon type probe initiators.” Inventors: María José Buitrago Serna; Manuel Cuenca Estrella; Juan Luis RodriguezTudela; Alicia Gómez López. Rights holder entity: Carlos III Health Institute. Application number: P200802665. Country of registration: Spain. Registration date: 09/19/2008. Grant date: 09/14/2011
b) Registered industrial property title: Riboflavin-synthese in Ashbya gossypii. Inventors/authors/breeders: Jose Luis Revuelta Doval; María José Buitrago Serna; Maria de los Angeles Santos García. Rights holder entity: BASF Aktiengesellschaft. Application number: CA 2186403. Registration date: 03/25/1994. Grant date: 01/24/2006
c) Registered industrial property title: Riboflavin-Synthese in Hefen. Inventors/authors/breeders: Jose Luis Revuelta Doval; Jose Javier García Ramírez; Maria de Los Angeles Santos García; Gloria Angélica González; María José Buitrago Serna. Rights holder entity: BASF Aktiengesellschaft. Application number: EP19940901793. Registration date: 11/19/199. Grant date: 05/07/1997
DIRECTION OF DOCTORAL THESES
1. Title: Development of new methods for diagnosis and identification of fungal species that cause opportunistic pneumonia. Implementation entity: Complutense University-ISCIII. Student: Clara Valero Fernández. Qualification obtained: Excellent Cum Laude. Defense date: 05/19/2017
2. Title: Development and Validation of diagnostic techniques for invasive fungal infection. Implementation entity: Complutense University of Madrid-ISCIII. Student: Sara Gago Prieto. Grade obtained: Excellent cum laude. Defense date: 07/18/2014
3. Title: Development of techniques based on real-time PCR for the diagnosis of invasive fungal infections. Implementation entity: Complutense University of
Madrid-ISCIII. Student: Leticia Bernal Martinez. Grade obtained: Excellent cum laude. Defense date: 2010