Triacetylfusarinine C: A urine biomarker for diagnosis of invasive aspergillosis.

Abstract

OBJECTIVES:

Early diagnosis of invasive aspergillosis (IA) remains challenging, with available diagnostics being limited by inadequate sensitivities and specificities. Triacetylfusarinine C, a fungal siderophore that has been shown to accumulate in urine in animal models, is a potential new biomarker for diagnosis of IA.

METHODS:

We developed a method allowing absolute and matrix-independent mass spectrometric quantification of TAFC. Urine TAFC, normalized to creatinine, was determined in 44 samples from 24 patients with underlying hematologic malignancies and probable, possible or no IA according to current EORTC/MSG criteria and compared to other established biomarkers measured in urine and same-day blood samples.

RESULTS:

TAFC/creatinine sensitivity, specificity, positive and negative likelihood ratio for probable versus no IA (cut-off ≥ 3) were 0.86, 0.88, 6.86, 0.16 per patient.

CONCLUSION:

For the first time, we provide proof for the occurrence of TAFC in human urine. TAFC/creatinine index determination in urine showed promising results for diagnosis of IA offering the advantages of non-invasive sampling. Sensitivity and specificity were similar as reported for GM determination in serum and bronchoalveolar lavage, the gold standard mycological criterion for IA diagnosis.

• Authors: Martin Hoenigl, Thomas Orasch, Klaus Faserl, Juergen Prattes, Juergen Loeffler, Jan Springer, Fabio Gsaller, Frederike Reischies, Wiebke Duettmann, Reinhard B Raggam, Herbert Lindner, Hubertus Haas
• Journal: The Journal of infection (J Infect) Vol. 78 Issue 2 Pg. 150-157 (02 2019) ISSN: 1532-2742 [Electronic] England
• PMID: 30267801 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Chemical References

• Biomarkers
• Ferric Compounds
• Hydroxamic Acids
• Siderophores
• N,N',N''-triacetylfusarinine C

Topics

• Adult
• Aged
• Aspergillosis (diagnosis, urine)
• Biomarkers (urine)
• Female
• Ferric Compounds (urine)
• Hematologic Neoplasms (complications, microbiology)
• Humans
• Hydroxamic Acids (urine)
• Immunocompromised Host
• Invasive Fungal Infections (diagnosis, urine)
• Middle Aged
• Sensitivity and Specificity
• Siderophores (urine)