SynthesisBMC pulmonary medicine2023
Bronchoalveolar lavage fluid polymerase chain reaction for invasive pulmonary aspergillosis among high-risk patients: a diagnostic meta-analysis.
Synthesis in BMC pulmonary medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 19 citations in OpenAlex.
- Impact of antimicrobial exposure on bronchoscopy yields in immunocompromised patients: a single-centre experience.Journal of thoracic disease · 2026Article
- Evaluation of the Prognostic Value of PCR Cycle Threshold and Mortality in Pulmonary Aspergillosis: A Retrospective Cohort Study.Infection and drug resistance · 2026Article
- Article
- Proposed Diagnostic Criteria for Invasive Pulmonary Aspergillosis in Patients with Autoimmune Inflammatory Rheumatic Diseases: A Proof-of-Concept Study.Journal of fungi (Basel, Switzerland) · 2025Article
- Role of liposomal amphotericin B in intensive care unit: an expert opinion paper.Journal of anesthesia, analgesia and critical care · 2025Review
- Dynamic analysis of the epidemiology and pathogen distribution of bronchoalveolar lavage fluid in children with severe pulmonary infection: a retrospective study.Italian journal of pediatrics · 2025Article
- Diagnostic Approach to Pneumonia in Immunocompromised Hosts.Journal of clinical medicine · 2025Review
- Evaluation of a novel aspergillus IgG lateral flow assay for the diagnosis of non-neutropenic patients with acute and subacute invasive aspergillosis.Frontiers in cellular and infection microbiology · 2025Article
- Development of RPA-Cas12a assay for rapid and sensitive detection of Pneumocystis jirovecii.BMC microbiology · 2024Article
- Culture-independent diagnostic approaches for invasive aspergillosis in solid organ transplant recipients.Korean journal of transplantation · 2023Review
- An Overview of Systematic Reviews of Polymerase Chain Reaction (PCR) for the Diagnosis of Invasive Aspergillosis in Immunocompromised People: A Report of the Fungal PCR Initiative (FPCRI)-An ISHAM Working Group.Journal of fungi (Basel, Switzerland) · 2023Review
- Secondary fungal infections in SARS-CoV-2 patients: pathological whereabouts, cautionary measures, and steadfast treatments.Pharmacological reports : PR · 2023Review
- Diagnosis and Treatment of Fungal Infections in Lung Transplant Recipients.Pathogens (Basel, Switzerland) · 2023Review
- Invasive fungal infections in patients with multiple myeloma: a possible growing problem in hematology and infectious diseases.Therapeutic advances in infectious diseaseReview
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundPolymerase chain reaction (PCR) assays are perceived to facilitate the diagnosis of fungal infections. However, due to lack of standardization, the value of bronchoalveolar lavage (BAL) fluid PCR in diagnosis of invasive pulmonary aspergillosis (IPA) remains unclear.
methodsWe conducted a systematic meta-analysis to evaluate the accuracy of BAL fluid PCR in IPA diagnosis among high-risk patients. All studies involving patients at risk for IPA were included. The sensitivity, specificity, positive and negative likelihood ratios of BAL fluid PCR were summarized for diagnosis of proven/probable IPA, or proven IPA only. Potential heterogeneity was assessed by subgroup analyses and meta-regression.
resultsForty-one studies involving 5668 patients were analyzed. The summary sensitivity, specificity, positive and negative likelihood ratios of BAL fluid PCR for proven/probable IPA were 0.75 (95% CI = 0.67-0.81), 0.94 (95% CI = 0.90-0.96), 11.8 (95% CI = 7.7-18.1) and 0.27 (95% CI = 0.20-0.36), respectively. Whereas for proven IPA only, sensitivity and specificity were 0.91 (95% CI = 0.68-0.98) and 0.80 (95% CI = 0.74-0.85) in fourteen studies involving 2061 patients. Significant heterogeneity was present due to the underlying disease, antifungal treatment and differences in DNA extraction techniques and choice of PCR assay. Compared to patients with hematological malignancies (HM) and hematopoietic stem cell/solid organ transplantation (HSCT/SOT), sensitivity was higher in the population with disease such as chronic obstructive pulmonary disease, solid tumor, autoimmune disease with prolonged use of corticosteroids, etc. (0.88 vs. 0.68, P < 0.001), which was related to the concurrent use of antifungal prophylaxis among patients with HM and HSCT/SOT.
conclusionBAL fluid PCR is a useful diagnostic tool for IPA in immunocompromised patients and is also effective for diagnosing IPA in patients without HM and HSCT/SOT. Furthermore, standard protocols for DNA extraction and PCR assays should be focused on to improve the diagnostic accuracy. Trial registration PROSPERO, registration number CRD42021239028.
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