Comparison of PCR-ELISA and galactomannan detection for the diagnosis of invasive aspergillosis

Molecular Detection of Invasive Aspergillosis in Hematologic Malignancies

“…Other studies recognized PCR-ELISA as a useful diagnostic tool for the detection and identification of fungal infections [19,20]. Scotter et al [21] reported that PCR-ELISA method is very sensitive for the diagnosis of IA but is associated with moderate rates of false positives. Therefore, the PCR-ELISA method was a very sensitive method in diagnostic assay which exhibited poor sensitivity but high specificity [21].…”

“…Scotter et al [21] reported that PCR-ELISA method is very sensitive for the diagnosis of IA but is associated with moderate rates of false positives. Therefore, the PCR-ELISA method was a very sensitive method in diagnostic assay which exhibited poor sensitivity but high specificity [21]. Buchheidt et al [22] evaluated IA using three methods (nested PCR, Light Cycler TM -mediated PCR, and galactomannan enzymelinked immunosorbent assay), and reported that in patients at high risk for IA, positive results for Aspergillus by PCR of blood samples are highly suggestive of IA and contribute to the diagnosis.…”

Challenges and progress in setting a standard for PCR for invasive aspergillosis

“…Clearly, there is a high LR+ only for the study of Raad et al [18]. The studies of Halliday et al [12•], Hebart et al [13,14], and Scotter et al [19] all yielded a high LR-but very low LR+. Hence, the studies all performed differently, with some leaning toward a high negative-predictive value, one toward a high positive-predictive value, and the remainder appearing indifferent.…”

“…In preparing a systematic review with Carlo Mengoli of the Department of Histology, Microbiology, and Medical Biotechnology, University of Padua, Padua, Italy and Mario Cruciani from the Centre of Preventive Medicine, HIV Outpatient Clinic, Verona, Italy based on the review of Boudewijns et al [5], we identifi ed 16 prospective cohort studies of consecutive patients at high risk for invasive aspergillosis akin to phase 2 drug studies [3,6-8,9•,10,11,12•, [13][14][15][16][17][18][19][20]. All compared the results of PCR with the diagnosis made following the original defi nitions for invasive fungal disease proposed by the EORTC/MSG or, for studies reported before the publication of these criteria in 2002, comparable criteria as a reference standard [1].…”

Polymerase Chain Reaction for Diagnosing Invasive Aspergillosis: Getting Closer but Still a Ways to Go

“…However, it may not be that simple, because Kami et al [17] showed that PCR detected the presence of Aspergillus earlier than did either galactomannan ELISA or the b-d-glucan test, and, in a later study, the same group found that combining the tests reduced sensitivity [18]. A smaller study [22] indicated why this might be, showing (using a variant of the method of Einsele et al [13]) that PCR was more sensitive than the galactomannan ELISA, whereas the latter test was more specific. The apparent discrepancies are likely to be partly the result of widely differing frequencies of probable and proven IA in the different populations, because the actual performance of any test is dependent on the a priori probability-that is, the prevalence.…”