TY  - JOUR
A1  - Boch, Tobias
A1  - Spiess, Birgit
A1  - Heinz, Werner
A1  - Cornely, Oliver A.
A1  - Schwerdtfeger, Rainer
A1  - Hahn, Joachim
A1  - Krause, Stefan W.
A1  - Duerken, Matthias
A1  - Bertz, Hartmut
A1  - Reuter, Stefan
A1  - Kiehl, Michael
A1  - Claus, Bernd
A1  - Deckert, Peter Markus
A1  - Hofmann, Wolf‐Karsten
A1  - Buchheidt, Dieter
A1  - Reinwald, Mark
T1  - Aspergillus specific nested PCR from the site of infection is superior to testing concurrent blood samples in immunocompromised patients with suspected invasive aspergillosis
JF  - Mycoses
N2  - Invasive aspergillosis (IA) is a severe complication in immunocompromised patients. Early diagnosis is crucial to decrease its high mortality, yet the diagnostic gold standard (histopathology and culture) is time‐consuming and cannot offer early confirmation of IA. Detection of IA by polymerase chain reaction (PCR) shows promising potential. Various studies have analysed its diagnostic performance in different clinical settings, especially addressing optimal specimen selection. However, direct comparison of different types of specimens in individual patients though essential, is rarely reported. We systematically assessed the diagnostic performance of an Aspergillus‐specific nested PCR by investigating specimens from the site of infection and comparing it with concurrent blood samples in individual patients (pts) with IA. In a retrospective multicenter analysis PCR was performed on clinical specimens (n = 138) of immunocompromised high‐risk pts (n = 133) from the site of infection together with concurrent blood samples. 38 pts were classified as proven/probable, 67 as possible and 28 as no IA according to 2008 European Organization for Research and Treatment of Cancer/Mycoses Study Group consensus definitions. A considerably superior performance of PCR from the site of infection was observed particularly in pts during antifungal prophylaxis (AFP)/antifungal therapy (AFT). Besides a specificity of 85%, sensitivity varied markedly in BAL (64%), CSF (100%), tissue samples (67%) as opposed to concurrent blood samples (8%). Our results further emphasise the need for investigating clinical samples from the site of infection in case of suspected IA to further establish or rule out the diagnosis.
KW  - antifungal
KW  - aspergillosis
KW  - BAL
KW  - blood
KW  - cerebrospinal fluid
KW  - comparison
KW  - PCR
KW  - Aspergillus
Y1  - 2019
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-214065
VL  - 62
IS  - 11
SP  - 1035
EP  - 1042
ER  -