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Diagnosing of invasive Aspergillosis during antifungal therapy by polymerase chain reaction on blood samples

Abstract number: 902_p1005

Lass-Flörl C.

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Objectives:

We evaluated the value of Aspergillus PCR as a tool for diagnosing invasive aspergillosis during antifungal therapy from whole blood samples.

Methods:

In a 3-year study, 36 patients receiving antifungal therapy due to chest radiographic findings highly suggestive for fungal pneumonia were evaluated. The PCR results of whole blood samples were compared with those obtained from bronchoalveolar lavage fluids and/or tissue specimens.

Results:

A total of 205 whole blood samples, 15 fine needle aspirations or tissue biopsy specimens, 21 bronchoalveolar lavage fluids and tracheal secrets were analysed using PCR. Fifteen patients had proven, nine probable and 12 possible invasive Aspergillus infections according to European Organization for Research and Treatment of Cancer/Mycosis Study Group definitions. In patients with proven infections, the sensitivities of PCR of lung and blood samples were 100 and 40%, respectively. The specificities were 100%. The negative predictive value of blood monitoring under antifungal treatment was 44%. In patients with probable infections, the sensitivities of PCR of lung fluids and blood were 66 and 44%, respectively. The specificities were 100%. The negative predictive value of blood monitoring under antifungal therapy was 58%.

Conclusions:

The benefits of PCR diagnosing of whole blood are limited if sampling takes place once treatment has started. The performance of Aspergillus PCR should be recommended in addition to microscopic examination and culture technique for sensitive detection of fungal infection.

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Session Details

Date: 01/08/2007
Time: 00:00-00:00
Session name: XXIst ISTH Congress
Subject:
Location: Oxford, UK
Presentation type:
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