Diagnostic performance of real-time polymerase chain reaction assay on blood for invasive aspergillosis and mucormycosis.

Abstract

OBJECTIVES:

This study aimed to evaluate the diagnostic usefulness of real-time (RT) polymerase chain reaction (PCR) on blood samples for diagnosis of invasive aspergillosis and mucormycosis in patients with suspected invasive mould infection.

METHODS:

Adult patients with suspected invasive mould infection were prospectively enrolled at a tertiary referral hospital in Seoul, South Korea between 2017 and 2020. Standard tests for diagnosis of invasive mould infection and RT-PCR for Aspergillus, Mucor and Rhizopus using blood samples were performed. We evaluated the diagnostic performance of RT-PCR tests in patients diagnosed with proven and probable invasive aspergillosis or mucormycosis infection, according to the modified definitions of the EORTC/MSG 2019.

RESULTS:

A total of 102 patients with suspected invasive mould infection were enrolled. Of these patients, 46 (45%) were classified as having proven (n = 13) or probable (n = 33) invasive aspergillosis, 21 (21%) as proven (n = 17) or probable (n = 4) invasive mucormycosis and 18 (18%) as possible invasive mould infection. The remaining 13 (13%) were classified as not having invasive mould infection. Patients with possible invasive mould infection (n = 18) and coinfection of aspergillosis and mucormycosis (n = 4) were excluded from the final analysis. The sensitivity and specificity of the Aspergillus PCR were 54.3% ([25/46], 95% confidence interval [CI]: 40.2-67.9%) and 94.1% ([32/34], 95% CI: 80.9-98.4%), respectively. The sensitivity and specificity of the Mucor or Rhizopus PCR were 57.1% ([12/21], 95% CI: 36.6-75.5%) and 76.3% ([45/59], 95% CI: 64.0-85.3), respectively.

CONCLUSIONS:

Our study suggests that blood PCR can be a useful adjunct test for diagnosing patients with suspected invasive mould infection.

• Authors: Hyeonji Seo, Ji Yeun Kim, Hyo-Ju Son, Jiwon Jung, Min Jae Kim, Yong Pil Chong, Sang-Oh Lee, Sang-Ho Choi, Yang Soo Kim, Sung-Han Kim
• Journal: Mycoses (Mycoses) Vol. 64 Issue 12 Pg. 1554-1562 (Dec 2021) ISSN: 1439-0507 [Electronic] Germany
• PMID: 34013523 (Publication Type: Evaluation Study, Journal Article)
• Copyright: © 2021 Wiley-VCH GmbH.

Topics

• Adult
• Aspergillosis (diagnosis)
• Aspergillus (genetics)
• Humans
• Invasive Fungal Infections (diagnosis)
• Mucor (genetics)
• Mucormycosis (diagnosis)
• Real-Time Polymerase Chain Reaction
• Republic of Korea
• Rhizopus (genetics)
• Sensitivity and Specificity
• Tertiary Care Centers