PCR as a Screening Test for Invasive Aspergillosis in Haematological Patients: A Pilot Study

Abstract

Invasive aspergillosis is a leading cause of morbidity and mortality in immunocompromised patients, particularly in individuals with haematological malignancy and in haematopoietic stem cell transplant recipients. Nowadays, the galactomannan (GM) assay has been widely used as an indication of invasive aspergillosis, even though the test is known to generate false-positive results. The aim of this study was to compare the performance of GM and real-time PCR (qPCR) to detected Aspergillus in blood samples obtained from high-risk haematological patients. Haematological patients were screened twice weekly with GM testing, which was performed by the Platelia ELISA kit. An additional sample of whole blood (4 ml) was obtained for the purpose of qPCR testing. Sixty-four samples from 12 patients with haematopoietic stem cell transplant or haematological malignancy were studied. The overall accordance between GM and qPCR tests was 96.9 % (62 samples). Only two samples showed contradictory results, with positive GM test and negative real-time PCR results. Based on the high concordance between GM and qPCR in terms of negative results, the main utility of qPCR could be in the confirmation of positive results seen with GM testing.

Detection of a Serum Siderophore by LC-MS/MS as a Potential Biomarker of Invasive Aspergillosis

“…This technique relies on amplification of the inter-transcribed (ITS) ribosomal region, or the 28S or 18S rRNA genes[ 18 , 19 , 28 ]. However, due to inefficient DNA extraction procedures, the requirement for large samples volumes[ 29 ], and non-standardized approaches, it has been suggested that qPCR and PCR be used as a confirmatory test rather than an initial diagnostic test[ 30 , 31 ] or in combination with other approved diagnostic tests[ 18 , 19 ]. Due to the problems associated with all of the current approaches and the need to treat invasive fungal infections in a timely manner, new diagnostic methods for IA are needed to improve clinical outcomes.…”