ArticleMedical mycology2019
Use of Aspergillus fumigatus real-time PCR in bronchoalveolar lavage samples (BAL) for diagnosis of invasive aspergillosis, including azole-resistant cases, in high risk haematology patients: the need for a combined use with galactomannan.
Article in Medical mycology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Guideline
- Bronchoalveolar lavage fluid polymerase chain reaction for invasive pulmonary aspergillosis among high-risk patients: a diagnostic meta-analysis.BMC pulmonary medicine · 2023Pooled it
- Invasive pulmonary aspergillosis in the ICU: the corticosteroid link.Pneumonia (Nathan Qld.) · 2026Review
- Azole-ResistantJournal of fungi (Basel, Switzerland) · 2025Review
- HTS and PCR Methods Are the Most Used in the Diagnosis of Aspergillosis: Advantages over Other Molecular Methods.Journal of fungi (Basel, Switzerland) · 2025Review
- [S1 guideline: diagnosis and treatment of invasive pulmonary aspergillosis in critically ill/intensive care patients].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Review
- The Role of Quantitative Real-Time PCR in the Invasive Pulmonary Aspergillosis Diagnosis: A Retrospective Study.Microorganisms · 2025Article
- Invasive Aspergillosis in the Intensive Care Unit.Journal of fungi (Basel, Switzerland) · 2025Review
- Reverse-transcriptase real-time PCR in the diagnostic strategy for invasive infections caused byJournal of clinical microbiology · 2024Article
- Current and Future Pathways inAntibiotics (Basel, Switzerland) · 2023Review
- Molecular mechanisms of acquired antifungal drug resistance in principal fungal pathogens and EUCAST guidance for their laboratory detection and clinical implications.The Journal of antimicrobial chemotherapy · 2022Review
- Antifungal Susceptibility Testing: A Primer for Clinicians.Open forum infectious diseases · 2021Review
- Review
- Evaluation of Three Commercial PCR Assays for the Detection of Azole-ResistantJournal of fungi (Basel, Switzerland) · 2021Article
- High-Frequency Direct Detection of Triazole Resistance inJournal of fungi (Basel, Switzerland) · 2020Article
- Detecting Azole-Antifungal Resistance inJournal of fungi (Basel, Switzerland) · 2020Review
- Diagnostic Performance of a Novel Multiplex PCR Assay for Candidemia among ICU Patients.Journal of fungi (Basel, Switzerland) · 2019Article
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Authors and funding
14 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Diagnosis of invasive aspergillosis (IA) is challenging, particularly in high-risk patients with lung lesions other than typical according to 2008-EORTC/MSG criteria. Even if microbiology is positive, they still remain unclassified according to 2008-EORTC/MSG. Quantitative polymerase chain reaction (qPCR) provides new mycological documentation of IA. This retrospective study assessed Aspergillus fumigatus real time qPCR (MycoGENIE®) in BAL to diagnose IA and identify azole-resistant strains. Clinical, radiological, and microbiological data from 114 hematology patients (69% HSCT recipients; 29% on mould active agents) from years 2012-2017 were collected; and 123 BAL samples were tested with qPCR (cutoff: Ct < 40) and galactomannan (GM, Platelia®, cutoff: 0.5 ODI). Patients were classified as proven/probable, possible, and no-IA. "Atypical-IA" referred to patients with lesions other than typical according to 2008-EORTC/MSG and positive mycology. Proven IA was diagnosed in two cases (1.6%), probable in 28 (22.8%), possible in 27 (22%), atypical in 14 (11.4%). qPCR was positive in 39 samples (31.7%). Sensitivity and specificity of qPCR for proven/probable IA (vs no-IA; atypical-IA excluded) were 40% (95% confidence interval [CI]: 23-59) and 69% (95%CI: 55-81), respectively. Sensitivity of qPCR was higher when combined with GM (83%, 95%CI: 65-94) and in those receiving mould-active agents at BAL (61%, 95%CI: 32-86). One sample had TR34/L98H mutation. In conclusion, in high-risk hematology patients with various lung lesions, A. fumigatus qPCR in BAL contributes to diagnosing IA, particularly if combined with GM and in patients receiving mould-active agents might allow detecting azole-resistant mutations in culture negative samples.
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