Universität zu Köln

Boch, Tobias, Spiess, Birgit, Heinz, Werner, Cornely, Oliver A., Schwerdtfeger, Rainer, Hahn, Joachim, Krause, Stefan W., Duerken, Matthias, Bertz, Hartmut, Reuter, Stefan, Kiehl, Michael, Claus, Bernd, Deckert, Peter Markus, Hofmann, Wolf-Karsten, Buchheidt, Dieter and Reinwald, Mark (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). S. 1035 - 1043. HOBOKEN: WILEY. ISSN 1439-0507

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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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Boch, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Spiess, Birgit UNSPECIFIED UNSPECIFIED UNSPECIFIED Heinz, Werner UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, Oliver A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schwerdtfeger, Rainer UNSPECIFIED UNSPECIFIED UNSPECIFIED Hahn, Joachim UNSPECIFIED UNSPECIFIED UNSPECIFIED Krause, Stefan W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Duerken, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Bertz, Hartmut UNSPECIFIED UNSPECIFIED UNSPECIFIED Reuter, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Kiehl, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Claus, Bernd UNSPECIFIED UNSPECIFIED UNSPECIFIED Deckert, Peter Markus UNSPECIFIED UNSPECIFIED UNSPECIFIED Hofmann, Wolf-Karsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Buchheidt, Dieter UNSPECIFIED UNSPECIFIED UNSPECIFIED Reinwald, Mark UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-129812
DOI:	10.1111/myc.12983
Journal or Publication Title:	Mycoses
Volume:	62
Number:	11
Page Range:	S. 1035 - 1043
Date:	2019
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1439-0507
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BRONCHOALVEOLAR LAVAGE SAMPLES; POLYMERASE-CHAIN-REACTION; FUNGAL-INFECTIONS; PULMONARY ASPERGILLOSIS; TRANSPLANT RECIPIENTS; HEMATOLOGY PATIENTS; ANTIFUNGAL THERAPY; DIAGNOSTIC-TESTS; GALACTOMANNAN; EPIDEMIOLOGY Multiple languages Dermatology; Mycology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/12981