Objectives: The aim of this study was to assess serological and molecular methods usefulness for diagnosis of invasive aspergilosis in patients with chronic granulomatous disease (CGD) presenting at the Children's Memorial Health Institute, Warsaw, Poland. Methods: Samples were obtained from 3 patients hospitalized in our institute with clinically proven or suspected active fungal infection. For all patients galactomannan detection (PLATELIA ASPERGILLUS TEST, BioRad) and polymerase chain reaction (nested-PCR) were performed in serum samples. Simultaneously, various clinical materials (blood, urine, BAL, CSF, sputum wound and mucosal swabs) were taken for routine, mycological diagnosis. All clinical samples were inoculated on Sabouraud plates and cultivated for 14 days at 28-30Â°C under aerobic conditions. Isolates were identified by microscopic and biochemical methods. Antifungal susceptibility testing was performed according to NCCLS recommendations. Results: For all patients, antigen detection results in serum samples were negative. In serum samples from two patients during active infection, Aspergillus DNA was detected by PCR method. During this time, Aspergillus fumigatus was also detectable in bronchoalveolar lavage fluid (BAL) of both patients and in cerebrospinal fluid (CSF) of single patient. In 1 of 3 patients with symptomatic pulmonary and sinusal aspergilosis, PCR result for Aspergillus sp. was negative. In both patients PCR results became negative after two months of antifungal treatment with voriconazole (VZ). Conclusions: 1. Our results indicate high usefulness of PCR method for Aspergillus sp. detection and empirical antifungal therapy monitoring in CGD patients. 2. Sandwich ELISA test for galactomannan detection in serum is not a reliable method for invasive aspergilosis diagnosis because of false negative results.
Full conference title:
16th European Congress of Clinical Microbiology and Infectious Diseases
- ECCMID 16th (2006)