Fungal DNA and beta-D-glucan (BG) as early markers of invasive fungal infections (IFI) in bronchoalveolar lavage fluids (BAL) and serum from critical patients

Ref ID: 19223

Author:

C.F. Orsi, C. Venturelli, C. Bettua, P. Pini, E. Dalbeni, G. Morace, M. Girardis, M. Luppi, F. Forghieri, S. Bigliardi, F. Luppi, M. Codeluppi, E. Blasi

Author address:

Milan, Modena, IT

Full conference title:

23rd European Congress of Clinical Microbiology and
Infectious Diseases

Date: 27 April 2014

Abstract:

Introduction: The incidence of IFI has been increasing, especially among immunocompromised patients, undergoing aggressive chemotherapy for cancer, bone marrow and organ transplantation, or advanced critical care. The mortality remains unacceptably high. Diagnosis of IFI is challenging, conventional microbiologial techniques are not sensitive and specific enough or require long times for identification. We investigated the performance of commercial assays in detecting early markers of IFI, namely fungal DNA and pan-fungal BG, in BAL and serum, from patients at risk of IFI.
Materials and Methods: Adult patients, hospitalized at the AOU-Modena during Jan-Oct 2012, were retrospectively clustered in a case-control study, according to clinical diagnosis and EORTC/MSG criteria, as follows: IA (proven/probable invasive aspergillosis), PCP (pulmonary pneumocystosis), IC (invasive candidiasis) and CTRL (non-IFI diagnosis). DNA extraction was performed by the MycXtra kit-Myconostica (BAL; 40 pt) or High Pure PCR Template Preparation Kit-Roche (serum; 34 pt); real time PCR amplification was performed by the MycAssay Aspergillus and MycAssay Pneumocystis (Myconostica) kits, employing the SmartCycler (Cepheid). The BG assessment in serum (27 pt) was performed by Fungitell assay (Cape Code), according to the manufacturer’s instructions. When available, serum and BAL as well as serial samples from the same patient were assessed. As routine, the Galactomann assay was also performed in most of the cases.
Results: The assay for Aspergillus DNA detection in BAL (9 IA; 31 CTRL) showed sensitivity, specificity, PPV and NPV of 90%, 94%, 82% and 100%, respectively; the assay for detection of Pneumocystis DNA (7 PCP; 33 CTRL) showed sensitivity of 100%, specificity of 91%, PPV of 70% and NPV of 100%. Low respiratory tract colonizations vs infections by Pneumocystis (3 vs 7 cases) were likely distinguishable, according to the Ct values. Moreover, the assay for Aspergillus DNA detection in serum (6 IA; 28 CTRL) showed sensitivity, specificity, PPV and NPV of 100%, 96%, 86% and 100%, respectively. Finally, the BG assay (8 IC; 19 CTRL) showed sensitivity, specificity, PPV and NPV of 95%, 87%, 88% and 95%, respectively.
Conclusions: By this pilot study, both the real time PCR and the BD assays show high levels of performance, thus encouraging their use to implement routine diagnosis; because of the high NPV, these assays may also facilitate monitoring of IFI risk patients.

Abstract Number: O164

Conference Year: 2013

Link to conference website: http://registration.akm.ch/einsicht.php?XNABSTRACT_ID=163442&XNSPRACHE_ID=2&XNKONGRESS_ID=180&XNMASK

New link: NULL

Conference abstracts, posters & presentations

Showing 10 posts of 17325 posts found.

  • Title

    Author

    Year

    Number

    Poster