Evaluation of the new AspID polymerase chain reaction assay for detection of Aspergillus species: A pilot study

Abstract

The newly developed AspID PCR assay for detection of Aspergillus spp. was evaluated with an interlaboratory quality control programme panel and human bronchoalveolar lavage fluid (BALF) samples. With the quality control programme, 8 out of 9 panel members were correctly identified. With the clinical study, 36 BALF samples that had been obtained from 18 patients with invasive pulmonary aspergillosis (IPA) and 18 without IPA were investigated. Sensitivity, specificity, positive and negative likelihood ratio for the AspID assay were 94.1% (95% CI 73.3-99.9), 76.5% (95% CI 50.1-93.2), 4 (95% CI 1.7-9.5) and 0.1 (95% CI 0.01-0.5) respectively.

Aspergillus fumigatusand aspergillosis: From basics to clinics

“…Molecular tests such as PCR ( Heldt et al. 2018 , Prattes et al. 2018 , Jenks et al.…”

Fungal infections diagnosis – Past, present and future

“…including: Aspergillus fumigatus TR34/L98H mutations Serum BAL Biopsy NA 71 – 100%/84.6 – 100% [ 195 , 200 , 201 ] Asp ID (OlmDiagnostics) Multiplex real-time PCR Unknown Aspergillus spp. including: Aspergillus terreus - BAL 90 minutes (excluding DNA extraction) 94.1%/76.5% [ [200] , [201] , [202] ] Cand ID® and Auris ID® (OlmDiagnostics) Multiplex real-time PCR Unknown Cand ID: Candida albicans Candida dubliniensis Candida glabrata Candida krusei Candida parapsilosis Candida tropicalis Auris ID: Candida auris - Cand ID: Plasma Synthetic BAL Auris ID: Blood 45 min (excluding DNA extraction) CandID: NA Auris ID: 96.6%/100% [ 185 , 203 ] FungiPlex® Candida (Bruker Daltonics) Multiplex real-time PCR Unknown Candida albicans Candida parapsilosis Candida dubliniensis Candida tropicalis Candida glabrata Candida krusei - WB Serum Plasma <2 h (excluding DNA extraction) 98.4 – 100%/94.1 – 99.8% [ 183 , 185 ] PneumoGenius (PathoNostics) Real-time PCR Mitochondrial ribosomal large subunit (rLSU) and t...…”

Treatment of Aspergillosis

“…Due to the absence of a single “gold standard” test for the diagnosis of IA, different mycological assays are employed and combined with clinical, radiological, and histological methods. Mycological diagnostic approaches for IA include fungal culture from BALF and biopsies; immunodetection of the cell wall component galactomannan (GM) in serum, BALF, and urine; detection of the cell wall component 1,3-β- d -glucan (BDG) via factor G activation in serum; detection of Aspergillus -specific siderophores in BALF or urine; detection of an Aspergillus -specific cell wall protein via a lateral flow device test (LFD); and detection of Aspergillus -specific DNA via PCR in blood and BALF [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ]. The most commonly used non-culture-based approach for IA diagnosis is GM detection in serum and BALF.…”

“…Given the reduced sensitivities of all available diagnostic tests in patients receiving mold-active antifungals, combination of multiple diagnostic tests and biomarkers from BALF and blood is the currently recommended approach, and has been shown to be associated with a significant increase of sensitivities, while specificities were only reduced slightly [ 19 , 20 , 23 , 30 , 32 , 41 , 42 , 43 ]. The most promising combinations include PCR and/or the Aspergillus -specific LFD and/or GM from BALF with serum GM and/or very high levels of serum interleukin 8, which has recently been shown to be highly sensitive and specific when combined with BALF LFD or PCR [ 19 , 22 , 23 , 26 , 27 , 30 , 32 , 33 ].…”