Reference : Comparison of Real-Time Aspergillus PCR with Platelia™AspergillusEIA in broncho-alveo...
Scientific congresses and symposiums : Poster
Human health sciences : Immunology & infectious disease
http://hdl.handle.net/2268/140697
Comparison of Real-Time Aspergillus PCR with Platelia™AspergillusEIA in broncho-alveolar lavage fluids for the diagnosis of invasive aspergillosis in neutropenic and non-neutropenic patients
English
RUZICKA, NADIA mailto []
BOREUX, Raphaël mailto [Centre Hospitalier Universitaire de Liège - CHU > > Microbiologie médicale >]
LEVAUX, Laetitia mailto [Centre Hospitalier Universitaire de Liège - CHU > > Microbiologie médicale >]
MEEX, Cécile mailto [Centre Hospitalier Universitaire de Liège - CHU > > Microbiologie médicale >]
HUYNEN, Pascale mailto [Centre Hospitalier Universitaire de Liège - CHU > > Microbiologie médicale >]
DODEMONT, Magali mailto [Centre Hospitalier Universitaire de Liège - CHU > > Microbiologie médicale >]
DESCY, Julie mailto [Centre Hospitalier Universitaire de Liège - CHU > > Microbiologie médicale >]
Melin, Pierrette mailto [Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Bactériologie, mycologie, parasitologie, virologie >]
Hayette, Marie-Pierre mailto [Université de Liège - ULiège > Département des sciences biomédicales et précliniques > Bactériologie, mycologie, parasitologie, virologie >]
27-Apr-2013
2x1m
Yes
International
23d European Congress of Clinical Microbiology and Infectious Diseases (ECCMID)
from 27-04-2013 to 30-04-2013
ESCMID
BERLIN
GERMANY
[en] Aspergillosis ; Galactomannan antigen ; PCR ; Bronchoalveolar lavage
[en] Objectives. Because of low sensitivity of fungal cultures and lack of standardization of Aspergillus PCR, laboratory diagnosis of invasive aspergillosis still relies on galactomannan (GM) detection in broncho-alveolar lavage (BAL) fluids and serum. The aim of this study was double: first, to assess the place of a 18S rRNA Aspergillus real-time PCR test performed in BAL fluid for the diagnosis of invasive aspergillosis (IA) in neutro- and non-neutropenic patients in comparison with GM detection; secondly, to evaluate the use of three different GM cut-off values.
Materials and methods. A total of 111 neutropenic and non-neutropenic patients hospitalized at the University hospital of Liège from March to October 2012 with suspicion of IA were included in the study. A total of 138 broncho-alveolar lavage fluids were evaluated by three laboratory diagnostic methods: 1/ culture on Sabouraud agar slants with antibiotics (bioMérieux, France) incubated at 28°C for 28 days; 2/ GM detection (Platelia ™Aspergillus EIA, Biorad) using GM index cut-off values at 0.5, 0.8 and 1, performed three times a week; 3/ a real-time Aspergillus PCR assay performed daily and targeting the 18S rRNA genes by using an in-house method. Clinical, radiological and microbiological data were reviewed for classification of patients.
Results. Nine patients developed probable or possible IA. The sensitivity/specificity/positive (VPP) and negative (NPV) predictive values (%) for culture, PCR, and GM using 0,5 as cut-off value were respectively 41/100/100/94, 58/97/70/96, and 91/83/34/99. The use of 0,8 and 1 as GM index cut-off values increased the specificity to 89 and 92% respectively, and the VPP to 44 and 54%. PCR had a better turn-around time and allowed the detection of Aspergillus colonisation.
Conclusion: GM detection in BAL fluids using a cut-off value of 1 was the most efficient laboratory test for the diagnosis of IA in neutropenic and non-neutropenic patients. Despite a lower sensitivity, PCR had a better VPP, and allowed the detection of culture-negative Aspergillus colonisations. A shorter turnaround time (TAT) due to daily practice of PCR tests may reduce the time-to-treatment up to 24 hours.
Researchers ; Professionals ; Students
http://hdl.handle.net/2268/140697

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