Diagnostic approach for Aspergillus infection: performance evaluation of a new molecular assay for detection and quantification of Aspergillus spp. in clinical samples

Author:

Rosamaria Tedeschi, Paola Stano, Lucia Pagani, Giada Lorenzi, Graziella Ciganotto, Paola Zigante, Alessandro Camporese

Author address:

Microbiology and Virology Unit, AAS5 S. Maria degli Angeli Hospital, Pordenone, Italy

Full conference title:

European Congress of Clinical Microbiology and Infectious Diseases 2020

Date: 2 July 2020

Abstract:

Background: The conventional diagnosis of Aspergillus infection is based on the presence of risk factors, radiological features, and microbiological results, i.e., histopathology and/or culture of Aspergillus spp. Important advances to the diagnostic field were brought by the introduction of non cultural tests in respiratory samples and blood, including PCR assay. Our study describes the performance of the new quantitative Real-Time PCR assay Aspergillus spp. ELITe MGB® Kit in association with ELITe InGenius instrument for Aspergillus spp detection in bronchoalveolar lavage (BAL) and plasma samples.

Materials/methods:Totally, 88 BAL and 82 plasma, collected in the period may-november 2019, were evaluated. The BAL were collected from patients undergoing bronchoscopy for monitoring or diagnosis of pulmonary infiltrates and blood samples were collected from immunocompromised and/or oncological patients in clinical follow-up. Clinical information was picked up during the routine diagnostic process; patients were classified as having IPA (proven/probable/possible) or no-IPA according to the EORTC/MSG diagnostic criteria. The Aspergillus spp. ELITe MGB® Kit in association with the ELITe InGenius® instrument (Elitech, Torino) is a quantitative real-time PCR with a target within the 28S rDNA. The volume of clinical sample required was 1ml. BAL fungal culture were also performed.

Results: The diagnostic specificity was 100% for BAL and 98% for plasma. The diagnostic sensitivity was 88.6% for BAL and 100% for plasma. The turnaround-time was about 150 minutes. PCR was positive in BAL from 24 patients: 6/24 (8.1%) had pulmonary chronic aspergillosis, 7/24 (9.4%) had invasive pulmonary aspergillosis and 11/24 (14.8%) had colonization.

Conclusions: Aspergillus spp. ELITe MGB® Kit in association with ELITe InGenius instrument is a highly sensitive method for detection and quantification of Aspergillus spp in BAL and plasma samples. This molecular system represents an innovative and fast solution with a simply laboratory workflow and a short report time. It is conceivable that the introduction of this assay in routine diagnosis and its incorporation into the patient care pathways could be a promising tool, in combination with other clinical information and biomarkers, for an improvement in detection and management of Aspergillus infection, and subsequently in the patient outcome.

Presenter email address: rosamaria.tedeschi@aas5.sanita.fvg.it

Abstract Number: 8179

Link to conference website:

Link Conference abstract: 

ECCMID 2020

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