Aspergillus PCR testing

• Verfasst von: Hummel, Margit [VerfasserIn]
• Verfasst von: Spiess, Birgit [VerfasserIn]
• Verfasst von: Cornely, Oliver A. [VerfasserIn]
• Verfasst von: Dittmer, Martin [VerfasserIn]
• Verfasst von: Mörz, Handan [VerfasserIn]
• Verfasst von: Buchheidt, Dieter [VerfasserIn]
• Titel: Aspergillus PCR testing
• Titelzusatz: results from a prospective PCR study within the AmBiLoad trial
• Verf.angabe: Margit Hummel, Birgit Spiess, Oliver A. Cornely, Martin Dittmer, Handan Mörz, Dieter Buchheidt
• E-Jahr: 2010
• Jahr: [August 2010]
• Umfang: 6 S.
• Fussnoten: First published: 14 July 2010 ; Gesehen am 01.06.2023
• Titel Quelle: Enthalten in: European journal of haematology
• Ort Quelle: Oxford : Wiley-Blackwell, 1987
• Jahr Quelle: 2010
• Band/Heft Quelle: 85(2010), 2, Seite 164-169
• ISSN Quelle: 1600-0609
• DOI: doi:10.1111/j.1600-0609.2010.01452.x
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Aspergillus PCR
• Sach-SW: hematologic malignancies
• Sach-SW: invasive aspergillosis
• Sach-SW: invasive fungal infection
• K10plus-PPN: 1847162991

Abstract

Objectives: Invasive fungal infection (IFI) is a major cause of morbidity and mortality in severely immunocompromised patients and is difficult to diagnose. The significance of molecular methods for diagnosis of IFI is still controversial. In a subset of patients treated within the AmBiLoad Trial, samples were investigated prospectively by a nested Aspergillus PCR assay to re-evaluate the significance of PCR in this setting. Patients and methods: In the randomized, prospective multicenter AmBiLoad trial, patients with proven or probable IFI were randomized to receive liposomal amphotericin B (L-AMB) 3 or 10 mg/kg QD for 14 d followed by L-AMB 3 mg/kg QD. From 91 patients, 459 serial samples (98% blood samples) were investigated by a nested PCR assay for Aspergillus DNA. All samples were investigated in our laboratory with a previously described nested and a quantitative PCR assay. As required by the study protocol, serial Aspergillus antigen galactomannan was performed. IFI was defined according to modified EORTC/MSG 2002 criteria as applied in the AmBiLoad trial. Results: Seven and 52 patients had proven and probable IFI according to modified EORTC/MSG criteria, respectively. The median number of samples investigated per patient was 4. Seventy percent of samples were obtained during treatment with antifungal study medication. Forty-three samples gave positive PCR results. Patients with an unfavorable outcome had a significantly higher rate of positive PCR results (48% versus 21%). Conclusions: The sensitivity of Aspergillus PCR testing is limited during antifungal therapy. The tendency for persistently positive PCR results to indicate a poor prognosis has to be confirmed in further studies.