Aspergillus specific nested PCR from the site of infection is superior to testing concurrent blood samples in immunocompromised patients with suspected invasive aspergillosis
Boch T, Spiess B, Heinz W, Cornely OA, Schwerdtfeger R, Hahn J, Krause S, Duerken M, Bertz H, Reuter S, Kiehl M, Claus B, Deckert PM, Hofmann WK, Buchheidt D, Reinwald M (2019)
Publication Type: Journal article
Publication year: 2019
Journal
Book Volume: 62
Pages Range: 1035-1042
Journal Issue: 11
DOI: 10.1111/myc.12983
Abstract
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.
Authors with CRIS profile
Involved external institutions
Klinikum Frankfurt (Oder)
Germany (DE)
HELIOS Kliniken
Germany (DE)
Universitätsklinikum Mannheim
Germany (DE)
Klinikum der Stadt Ludwigshafen am Rhein gGmbH
Germany (DE)
Medizinische Hochschule Brandenburg "Theodor Fontane" / Brandenburg Medical School "Theodor Fontane"
Germany (DE)
Universitätsklinikum Regensburg
Germany (DE)
Universitätsklinikum Freiburg
Germany (DE)
Universitätsklinikum Würzburg
Germany (DE)
Klinikum Leverkusen
Germany (DE)
Universitätsklinikum Köln
Germany (DE)
Germany (DE)
HELIOS Kliniken
Germany (DE)
Universitätsklinikum Mannheim
Germany (DE)
Klinikum der Stadt Ludwigshafen am Rhein gGmbH
Germany (DE)
Medizinische Hochschule Brandenburg "Theodor Fontane" / Brandenburg Medical School "Theodor Fontane"
Germany (DE)
Universitätsklinikum Regensburg
Germany (DE)
Universitätsklinikum Freiburg
Germany (DE)
Universitätsklinikum Würzburg
Germany (DE)
Klinikum Leverkusen
Germany (DE)
Universitätsklinikum Köln
Germany (DE)
How to cite
APA:
Boch, T., Spiess, B., Heinz, W., Cornely, O.A., Schwerdtfeger, R., Hahn, J.,... Reinwald, M. (2019). Aspergillus specific nested PCR from the site of infection is superior to testing concurrent blood samples in immunocompromised patients with suspected invasive aspergillosis. Mycoses, 62(11), 1035-1042. https://doi.org/10.1111/myc.12983
MLA:
Boch, Tobias, et al. "Aspergillus specific nested PCR from the site of infection is superior to testing concurrent blood samples in immunocompromised patients with suspected invasive aspergillosis." Mycoses 62.11 (2019): 1035-1042.
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