Invasive aspergillosis (IA) is the leading cause of invasive mold infection in immunosupressed cancer patients. The recovery of Aspergillus spp by culture methods is generally poor, even in patients with advanced IA, and therefore the true incidence of IA is underestimated. Although this poor culture yield has been estimated from autopsy series in the past, there is little recent data on the culture recovery from antemortem patients. Here we reviewed our recent experience with the sensitivity of culture recovery of Aspergillus spp. both from antemortem and postmortem cultures of immunosupressed patients with histologically-documented IA. Forty nine such patients, 21 autopsies from 1999 and 28 antemortem cases between 1998 and 1999 were identified. The distribution of Aspergillus species was - between autopsy and antemortem cases; among 15 cases of histologically proven IA with a positive culture (31% of all 49 cases), 4 were due to A. fumigatus, 7 were due to A. flavus, 3 were due to A. terreus, and one was due to A. niger. In autopsy-proven IA the yield from autopsy culture from tissues with histologic involvement was 33% (7 of 21). The yield from antemortem cultures averaged 29% (8 of 28) from sites with histiologically documented IA, excluding BAL and bronchial washings or other contamination prone sources. Our data support the need for novel non-culture based approaches for the early diagnosis of IA.
Full conference title:
- IDSA 38th