Polimerase Chain Reaction (PCR) in the Diagnosis of Invasive Aspergillosis (IA): A Meta-Analysis.

M. CRUCIANI1, C. MENGOLI 2, O. BOSCO 1, G. SERPELLONI 1, M. MALENA 1;

Author address: 

1Ctr. of Preventive Med., Verona, Italy, 2Univ. of Padua, Padua, Italy.

Abstract: 

Background: In order to obtain an overview of the diagnostic accuracy of PCR techniques for the diagnosis of IA, we performed a meta-analysis. Methods: Studies using PCR techniques were included when: i) used the EORTC criteria as a reference standard (Ascioglu et al, Clin Infect Dis, 2002, 34:7), ii) were conducted in a consecutive series of patients; and iii) provided data on sensitivity and specificity. We calculated summary receiving operating characteristic (sROC) curve, Area under the curve (AUC), diagnostic odds ratio, pooled sensitivity and specificity. Results: 8 studies from 2001 to 2006 reported the performance of PCR on blood samples from immunocompromised pts, mostly with hematological disorders; in 4 of these studies the performance of galactomannan (GM) assay was also reported. The PCR techniques used were: real-time PCR (4 studies), PCR-ELISA (2) and nested PCR i(2). Overall, the PCR had a sensitivity of 0.70 (95% confidence interval [CI], 0.51-0.84) and specificity of 0.90 (95% CI, 0.85-0.93) for proven+probable cases of IA. Compared to PCR, GM assay was less sensitive (0.61; 95 % CI, 0.31-0.84) but slightly more specific (0.93; 95 % CI, 0.80-0.97). The sROC curves of PCR and GM assay are reported in the figure. Conclusions: The PCR tecniques have moderate accuracy for diagnosis of IA in immunocompromised patients. PCR was superior to GM assay with respect to sensitivity rates
2006

abstract No: 

M-1615

Full conference title: 

46th Interscience Conference on Antimicrobial Agents and Chemotherapy
    • ICAAC 46th