Combination of Aspergillu s mitochondrial and ribosomal QPCR for early diagnosis of invasive aspergillosis in hematology patients

Ref ID: 19575

Author:

L Millon1,2*, A Berceanu3, AP Bellanger1,2, F Larose3, F Grenouillet1,2, E Deconinck3

Author address:

1Parasitology-Mycology, University Hospital, Besancon, France
2UMR CNRS ChronoEnvironnement, Franche-Comté University, Besancon, France
3Clinical Hematology, University Hospital, Besancon, France

Full conference title:

6th Advances Against Aspergillosis 2014

Abstract:

Purpose:
A combination of two quantitative Aspergillus PCR assays, targeting a mitochondrial and a ribosomal
target (mtQPCR), have proved efficacy for diagnosis of invasive aspergillosis in hematology patients
with risk factors and a positive galactomannan antigen (GM) (1). However, in that study, Aspergillus
circulating DNA detection using mtQPCR was done only when GM was positive, and we have
never assessed mtQPCR for screening at risk patients. The aim of the present study was to assess the
performance of mtQPCR for screening at risk patients in a Hematology Intensive Care Unit.
Methods:
The study was perfromed in the Hematology Intensive Care Unit from Besançon University
Hospital from March 2012 to September 2013. GM detection (Platelia Aspergillus (Bio-Rad,
France)) and mtQPCR were performed on the same serum sample, twice a week, in all patients with
risk factors for invasive aspergillosis. Risk factors, clinical, radiological and biological data were
prospectively recorded using the information sheet from the French network for surveillance of IA.
Results:
Twenty five patients were diagnosed with probable or proven invasive aspergillosis according
to 2008 EORTC/MSG criteria. 13/25 patients had a positive mtQPCR. Both mitochondrial and
ribosomal QPCR assays were positive in 5/13 patients. Mitochondrial QPCR assay was the only
positive in 1/13 patient, and ribosomal QPCR assay was the only positive in 7/13 patients. Out of
the 13 patients with positive mtQPCR, 9/13 had a positive GM at the same time (GM index > 0.5),
and 4/13 had a negative GM at the time of the positive mtQPCR. The first positive GM was obtained
from 10 to 30 days after the first positive PCR for 3 out of these 4 patients. For the 4th patient, a
positive A. fumigatus culture from a sputum was obtained 15 days after the first positive PCR.
Conclusion:
Screening at risk patients using both mtQPCR and GM on the same serum sample is easily feasible in
routine clinical setting. Our results confirm the usefulness of combination of biomarkers to improve
early diagnosis of invasive aspergillosis.
(1) Millon et al, J Clin Microbiol 2011, 49:1058-1063

Abstract Number: 101

Conference Year: 2014

Link to conference website: http://www.AAA2014.org

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