Universität zu Köln

Boch, T., Spiess, B., Cornely, O. A., Vehreschild, J. J., Rath, P. M., Steinmann, J., Heinz, W. J., Hahn, J., Krause, S. W., Kiehl, M. G., Egerer, G., Liebregts, T., Koldehoff, M., Klein, M., Nolte, F., Mueller, M. C., Merker, N., Will, S., Mossner, M., Popp, H., Hofmann, W-K., Reinwald, M. and Buchheidt, D. (2016). Diagnosis of invasive fungal infections in haematological patients by combined use of galactomannan, 1,3-beta-D-glucan, Aspergillus PCR, multifungal DNA-microarray, and Aspergillus azole resistance PCRs in blood and bronchoalveolar lavage samples: results of a prospective multicentre study. Clin. Microbiol. Infect., 22 (10). S. 862 - 869. OXFORD: ELSEVIER SCI LTD. ISSN 1469-0691

Full text not available from this repository.

Abstract

High mortality rates of invasive fungal disease (IFD), especially invasive aspergillosis (IA), in immuno-compromised haematological patients and current diagnostic limitations require improvement of detection of fungal pathogens by defining the optimal use of biomarkers and clinical samples. Concurrent bronchoalveolar lavage (BAL) and peripheral blood samples of 99 haematological patients with suspected IFD were investigated within a multicentre prospective study. Diagnostic performance of a galactomannan (GM) enzyme immune assay (EIA), a 1,3-beta-D-glucan assay (BDG), an Aspergillus PCR, and a multifungal DNA-microarray (Chip) alone or in combination were calculated. IFD were classified as proven (n = 3), probable (n = 34), possible (n = 33), and no IFD (n = 29) according to EORTC/MSG criteria. GM, PCR, and Chip showed superior diagnostic performance in BAL than in blood, whereas specificity of BDG in BAL was poor (48% (14/29)). The combination of GM (BAL) with BDG (blood) showed sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and DOR (diagnostic odds ratio) of 92% (34/37), 93% (27/29), 94%, 90%, and 153.0, respectively. Combining GM (BAL) with PCR (BAL) showed convincing diagnostic potential for diagnosing IA with sensitivity, specificity, PPV, NPV, and DOR of 85% (17/20), 97% (28/29), 94%, 90%, and 158.7. Addition of the DNA-microarray resulted in further detection of two mucormycetes infections. In 1 out of 15 Aspergillus DNA-positive samples a triazole resistance-mediating Cyp51A mutation was found. Combination of biomarkers is superior to their sole use in diagnosing IFD, particularly IA. Integrating blood and BAL samples into a diagnostic algorithm is an advantageous approach. (C) 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Boch, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Spiess, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, O. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vehreschild, J. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Rath, P. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Steinmann, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Heinz, W. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hahn, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Krause, S. W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kiehl, M. G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Egerer, G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Liebregts, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Koldehoff, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Klein, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Nolte, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, M. C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Merker, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Will, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mossner, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Popp, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hofmann, W-K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Reinwald, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Buchheidt, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-261381
DOI:	10.1016/j.cmi.2016.06.021
Journal or Publication Title:	Clin. Microbiol. Infect.
Volume:	22
Number:	10
Page Range:	S. 862 - 869
Date:	2016
Publisher:	ELSEVIER SCI LTD
Place of Publication:	OXFORD
ISSN:	1469-0691
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language LATERAL-FLOW DEVICE; POLYMERASE-CHAIN-REACTION; LINKED-IMMUNOSORBENT-ASSAY; CELL TRANSPLANT RECIPIENTS; PRIMARY CLINICAL-SAMPLES; REAL-TIME PCR; BETA-D-GLUCAN; PULMONARY ASPERGILLOSIS; ENZYME-IMMUNOASSAY; IMMUNOCOMPROMISED PATIENTS Multiple languages Infectious Diseases; Microbiology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/26138