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Detection of Aspergillus DNA by a nested PCR assay with high sensitivity and specificity rates is able to improve the diagnosis of invasive aspergillosis in paediatric patients

Abstract number: O451

Hummel M., Spiess B., Roder J., von Komorowski G., Duerken M., Kentouche K., Laws H., Moerz H., Buchheidt D.

Background. Fungal infections are a leading cause of morbidity and mortality in severely immunocompromised patients with an increasing incidence in recent years. IA is the most common filamentous fungal infection and is, in adults as well as in children, difficult to diagnose. To improve the outcome of patients with invasive aspergillosis (IA), early diagnosis and treatment initiation is crucial.

Several PCR assays to detect Aspergillus DNA have been established, but so far, studies on molecular tools for the diagnosis of IA in children are few.

We evaluated the results of a nested PCR assay to detect Aspergillus DNA in clinical samples from paediatric and adolescent patients with suspected IA.

Methods. Blood and non-blood samples from immunocompromised paediatric and adolescent patients with suspected invasive fungal infection were sent for processing Aspergillus polymerase chain reaction (PCR) to our laboratory and investigated with our previously described nested PCR assay. PCR results from consecutive patients from three university children hospitals investigated between November 2000 and January 2007 were evaluated. Fungal infections were classified according to the EORTC classification on the grounds of clinical findings, microbiology and radio-imaging results.

Results. 291 samples from 71 patients were investigated for the presence of Aspergillus DNA by our previously described nested PCR assay. Two, 3 and 34 patients had proven, probable and possible IA, respectively. Aspergillus DNA was detected in blood, cerebrospinal fluid (CSF) and in bronchoalveolar lavage (BAL) samples. Sensitivity and specificity rates of the PCR assay were 80 and 81%, respectively

Conclusion. Our nested PCR assay is able to detect Aspergillus DNA in blood, CSF and BAL samples from paediatric and adolescent patients with IA with high sensitivity and specificity rates. PCR for Aspergillus DNA contributes essentially to improve the diagnosis of IA.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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