Aspergillus specific nested PCR from the site of infection is superior to testing concurrent blood samples in immunocompromised patients with suspected invasive aspergillosis.
Adolescent
Adult
Aged
Aspergillosis
/ blood
Aspergillus
/ isolation & purification
Child
Child, Preschool
Female
Humans
Immunocompromised Host
Invasive Fungal Infections
/ blood
Male
Middle Aged
Molecular Diagnostic Techniques
/ methods
Polymerase Chain Reaction
/ standards
Retrospective Studies
Sensitivity and Specificity
Young Adult
Aspergillus
PCR
BAL
antifungal
aspergillosis
blood
cerebrospinal fluid
comparison
Journal
Mycoses
ISSN: 1439-0507
Titre abrégé: Mycoses
Pays: Germany
ID NLM: 8805008
Informations de publication
Date de publication:
Nov 2019
Nov 2019
Historique:
received:
05
03
2019
revised:
29
07
2019
accepted:
30
07
2019
pubmed:
14
8
2019
medline:
25
2
2020
entrez:
13
8
2019
Statut:
ppublish
Résumé
Invasive aspergillosis (IA) is a severe complication in immunocompromised patients. Early diagnosis is crucial to decrease its high mortality, yet the diagnostic gold standard (histopathology and culture) is time-consuming and cannot offer early confirmation of IA. Detection of IA by polymerase chain reaction (PCR) shows promising potential. Various studies have analysed its diagnostic performance in different clinical settings, especially addressing optimal specimen selection. However, direct comparison of different types of specimens in individual patients though essential, is rarely reported. We systematically assessed the diagnostic performance of an Aspergillus-specific nested PCR by investigating specimens from the site of infection and comparing it with concurrent blood samples in individual patients (pts) with IA. In a retrospective multicenter analysis PCR was performed on clinical specimens (n = 138) of immunocompromised high-risk pts (n = 133) from the site of infection together with concurrent blood samples. 38 pts were classified as proven/probable, 67 as possible and 28 as no IA according to 2008 European Organization for Research and Treatment of Cancer/Mycoses Study Group consensus definitions. A considerably superior performance of PCR from the site of infection was observed particularly in pts during antifungal prophylaxis (AFP)/antifungal therapy (AFT). Besides a specificity of 85%, sensitivity varied markedly in BAL (64%), CSF (100%), tissue samples (67%) as opposed to concurrent blood samples (8%). Our results further emphasise the need for investigating clinical samples from the site of infection in case of suspected IA to further establish or rule out the diagnosis.
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1035-1042Informations de copyright
© 2019 The Authors. Mycoses published by Blackwell Verlag GmbH.
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