Universität zu Köln

Reinwald, M., Spiess, B., Heinz, W. J., Heussel, C. P., Bertz, H., Cornely, O. A., Hahn, J., Lehrnbecher, T., Kiehl, M., Laws, H. J., Wolf, H. H., Schwerdtfeger, R., Schultheis, B., Burchardt, A., Klein, M., Duerken, M., Claus, B., Schlegel, F., Hummel, M., Hofmann, W-K. and Buchheidt, D. (2013). Aspergillus PCR-Based Investigation of Fresh Tissue and Effusion Samples in Patients with Suspected Invasive Aspergillosis Enhances Diagnostic Capabilities. J. Clin. Microbiol., 51 (12). S. 4178 - 4186. WASHINGTON: AMER SOC MICROBIOLOGY. ISSN 1098-660X

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Abstract

Although it is a severe complication in immunocompromised patients, diagnosing invasive fungal disease (IFD), especially invasive aspergillosis (IA), remains difficult. In certain clinical scenarios, examining tissue samples for identification of the infectious organism becomes important. As culture-based methods rarely yield results, the performance of an Aspergillus-specific nested PCR in fresh tissue or pleural effusion samples was evaluated. Fresh tissue (n = 59) and effusion (n = 47) specimens from 79 immunocompromised patients were subjected to an Aspergillus-specific PCR assay. Twenty-six patients had proven (n = 20) or probable (n = 6) IFD, according to the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) criteria, while the remaining patients were classified as having either possible IFD (n = 30) or no IFD (n = 23). IA was identified as the underlying IFD in 21/26 proven/probable cases. PCR positivity was observed for 18/21 proven/probable and 6 possible IA cases; cases classified as no IA did not show positive signals. Patients with proven IFD (n = 5) with cultures positive for non-Aspergillus molds also had negative Aspergillus PCR results. Aspergillus PCR performance analysis yielded sensitivity and specificity values of 86% (95% confidence interval [CI], 65% to 95%) and 100% (95% CI, 86% to 100%), respectively, thus leading to a diagnostic odds ratio of >200. In this analysis, good diagnostic performance of the PCR assay for detection of IA was observed for tissue samples, while effusion samples showed lower sensitivity rates. PCR testing represents a complementary tool; a positive PCR result strengthens the likelihood of IA, whereas IA seems unlikely in cases with negative results but findings could indicate non-Aspergillus IFD. Thus, PCR testing of these specimens enhances the diagnostic capabilities.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Reinwald, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Spiess, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Heinz, W. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Heussel, C. P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bertz, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, O. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hahn, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lehrnbecher, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kiehl, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Laws, H. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wolf, H. H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schwerdtfeger, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schultheis, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Burchardt, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Klein, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Duerken, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Claus, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schlegel, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hummel, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hofmann, W-K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Buchheidt, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-471516
DOI:	10.1128/JCM.02387-13
Journal or Publication Title:	J. Clin. Microbiol.
Volume:	51
Number:	12
Page Range:	S. 4178 - 4186
Date:	2013
Publisher:	AMER SOC MICROBIOLOGY
Place of Publication:	WASHINGTON
ISSN:	1098-660X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BRONCHOALVEOLAR LAVAGE SAMPLES; FUNGAL-INFECTIONS; PULMONARY ASPERGILLOSIS; MOLD INFECTIONS; IMMUNOCOMPROMISED PATIENTS; TRANSPLANT RECIPIENTS; CLINICAL-APPLICATION; MOLECULAR METHODS; IDENTIFICATION; DNA Multiple languages Microbiology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/47151