Detection of Invasive Aspergillosis

Thornton, Christopher R.

doi:10.1016/s0065-2164(10)70006-x

Cited by 61 publications

(48 citation statements)

References 169 publications

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“…Early and accurate diagnosis followed by appropriate antifungal therapy is vital for a favourable outcome . However, in the absence of an accurate 'gold standard', the diagnosis of IA remains challenging (Guinea & Bouza, 2014;Johnson et al, 2014;Thornton, 2010). Microbiological tests have become the most important factor of the diagnostic criteria, as tissue biopsy has contra-indications and fungal cultures are neither highly sensitive nor highly specific.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of a novel lateral-flow device in invasive aspergillosis: a meta-analysis

Pan

Zhang

et al. 2015

Journal of Medical Microbiology

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A novel lateral-flow device (LFD) has been invented for use as a diagnostic tool for invasive aspergillosis (IA). We conducted a meta-analysis to assess the diagnostic accuracy of the device. Published studies that used the European Organization for Research and Treatment of Cancer/Mycoses Study Group criteria and provided sufficient data were included. Two reviewers independently collected the data from each study and assessed the risk bias using the Quality Assessment of Diagnostic Accuracy Studies-2. The pooled sensitivity, specificity and diagnostic odds ratio (DOR) were computed and reported with a 95 % confidence interval 90 (95 % CI,) in the LFD test using serum. We concluded that the Aspergillus LFD had a good diagnostic value in immunocompromised patients at risk of IA. The BAL LFD might have a better performance than the serum LFD test.

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Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of a novel lateral-flow device in invasive aspergillosis: a meta-analysis

Pan

Zhang

et al. 2015

Journal of Medical Microbiology

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“…The immune status of the host and the virulence of the strain determine which disease is likely to occur. Allergic Aspergillus sinusitis, allergic bronchopulmonary aspergillosis (ABPA), and hypersensitivity pneumonias generally occur in asthma and cystic fibrosis patients and are a result of hypersensitivity to inhaled spores or germlings (3,13,55). Saprophytic infections, commonly called aspergillomas, occur when the fungus invades preexisting cavities in the lungs and forms clumps of mycelia that secrete toxins and allergens (55).…”

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confidence: 99%

“…Allergic Aspergillus sinusitis, allergic bronchopulmonary aspergillosis (ABPA), and hypersensitivity pneumonias generally occur in asthma and cystic fibrosis patients and are a result of hypersensitivity to inhaled spores or germlings (3,13,55). Saprophytic infections, commonly called aspergillomas, occur when the fungus invades preexisting cavities in the lungs and forms clumps of mycelia that secrete toxins and allergens (55). Invasive aspergillosis, in which hyphae breach epithelial and endothelial barriers and spread via the bloodstream, occurs in severely immunocompromised individuals, including leukemia patients, solid-organ and bone marrow transplant patients, individuals with genetic immunodeficiencies (such as chronic granulomatous disease), patients with AIDS, and cancer patients undergoing cytotoxic chemotherapy (10,13).…”

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confidence: 99%

“…In a strain of Saccharomyces cerevisiae deficient in high-affinity iron uptake and lacking endogenous siderophore transporters, investigation of expression of MirA, MirB, and MirC by use of 55 Fe-labeled siderophore uptake assays revealed that in A. nidulans, MirA and MirB are enterobactin and TAFC transporters, respectively. Both transporters are highly specific and are functionally similar to the S. cerevisiae Enb1p/Arn4p and Taf1p/Arn2p transporters (20).…”

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confidence: 99%

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Structural Requirements for the Activity of the MirB Ferrisiderophore Transporter of Aspergillus fumigatus

et al. 2012

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Siderophores have been identified as virulence factors in the opportunistic fungal pathogen Aspergillus fumigatus. The 14-pass transmembrane protein MirB is postulated to function as a siderophore transporter, responsible for uptake of the hydroxamate siderophore N,N=,N؆-triacetylfusarinine C (TAFC). Our aim was to identify amino acids of A. fumigatus MirB that are crucial for uptake of TAFC. Site-directed mutagenesis was used to create MirB mutants. Expression of wild-type and mutant proteins in the Saccharomyces cerevisiae strain PHY14, which lacks endogenous siderophore transporters, was confirmed by Western blotting. TAFC transport assays using 55 Fe-labeled TAFC and growth assays with Fe-TAFC as the sole iron source identified alanine 125, tyrosine 577, loop 3, and the second half of loop 7 (Loop7Del2) as crucial for function, since their substitution or deletion abrogated uptake completely. Wild-type MirB transported ferricrocin and coprogen as well as TAFC but not ferrichrysin. MirB was localized by fluorescence microscopy using antisera raised against a MirB extracellular loop peptide. Immunofluorescence microscopy showed that in yeast, wild-type MirB had a punctate distribution under the plasma membrane, as did the A125D and Y577A strains, indicating that the defect in transport of these mutants was unlikely to be due to mislocalization or degradation. MirB immunolocalization in A. fumigatus showed that the transporter was found in vesicles which cycled between the cytoplasm and the plasma membrane and was concentrated at the hyphal tips. The location of MirB was not influenced by the presence of the siderophore TAFC but was sensitive to internal iron stores.

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“…GM detection in serum and BAL fluids as a means of establishing early diagnosis of IA in patients at risk is very promising. GM test shows a sensitivity that may range from 60% to 100% and specificity from 81% to 99% in neutropenic patients, depending of the tested sample (serum or BAL) and cut-off values (14,36).…”

Section: Introductionmentioning

confidence: 99%

Invasive Aspergillosis in Intensive Care Unit Patients in Iran

Hedayati

Khodavaisy

Amini

et al. 2013

Acta Med. (Hradec Kralove, Czech Repub.)

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Summary:We assessed the intensive care unit (ICU) patients for Invasive aspergillosis (IA) with culture and non-culture based diagnostic methods from Iran. Thirty-six ICU patients with underlying predisposing conditions for IA were enrolled in the study. Sixty eight Bronchoalveolar lavage (BAL) samples were collected by bronchoscope twice a weekly. BAL samples were analyzed by microscopic examination, fungal culture and galactomannan (GM) detection. The Platelia Aspergillus GM EIA was used to quantify GM indices. Samples with a BAL GM index ≥1 were considered as positive for GM. Patients were classified as having probable or possible IA. Out of 36 suspected patients to IA, 36.1% of cases showed IA which were categorized as: 4 cases of possible IA and 9 of probable IA. 76.2% of BAL samples were positive for GM. From 13 patients with IA, 11 (84.6%) had at least one positive BAL GM index. Of these patients, 9 (81.8%) showed probable IA. The main underlying predisposing conditions were neutropenia (53.8%) and COPD (30.8%). Our study has indicated that COPD must be considered as one of the main predisposing condition for occurrence of aspergillosis in ICU patients. Our data have also revealed that GM detection in BAL samples play a significant role to IA diagnosis.

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Detection of Invasive Aspergillosis

Cited by 61 publications

References 169 publications

Diagnostic accuracy of a novel lateral-flow device in invasive aspergillosis: a meta-analysis

Diagnostic accuracy of a novel lateral-flow device in invasive aspergillosis: a meta-analysis

Structural Requirements for the Activity of the MirB Ferrisiderophore Transporter of Aspergillus fumigatus

Invasive Aspergillosis in Intensive Care Unit Patients in Iran

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