ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2023
Clinical Impact of Polymerase Chain Reaction-Based Aspergillus and Azole Resistance Detection in Invasive Aspergillosis: A Prospective Multicenter Study.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
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33 citing papers in PubMed, 53 citations in OpenAlex.
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- Clinical Characteristics and Risk Factors for Mortality in Candidemia: A Retrospective Single-Center Study in China.Infection and drug resistance · 2026Article
- Investigation of azole resistance inJournal of medical microbiology · 2026Article
- Evaluation of the Prognostic Value of PCR Cycle Threshold and Mortality in Pulmonary Aspergillosis: A Retrospective Cohort Study.Infection and drug resistance · 2026Article
- 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
- Classifying patients with invasive fungal disease: towards a unified case definition?The Journal of antimicrobial chemotherapy · 2025Article
- Article
- COVID-19-associated Pulmonary Aspergillosis in Mechanically Ventilated Patients at 7 US Hospitals: Epidemiology and Estimated Likelihood of Invasive Pulmonary Aspergillosis-Results of the Prospective MSG-017 Study.Open forum infectious diseases · 2025Article
- Doubling of triazole resistance rates in invasive aspergillosis over a 10-year period, Belgium, 1 April 2022 to 31 March 2023.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025Article
- Role of liposomal amphotericin B in intensive care unit: an expert opinion paper.Journal of anesthesia, analgesia and critical care · 2025Review
- Towards a holistic approach to pulmonary infections. Insights from the Sixth Annual Meeting of Spanish Experts 2024.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2025Review
- Article
- Comprehensive Review of Environmental Surveillance for Azole-ResistantJournal of fungi (Basel, Switzerland) · 2025Review
- Detection and Management of Invasive Mold Disease in Pediatric Hematological Cancer Patients.Infection and drug resistance · 2025Review
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Authors and funding
34 authors at 13 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInvasive aspergillosis (IA) by a triazole-resistant Aspergillus fumigatus is associated with high mortality. Real-time resistance detection will result in earlier initiation of appropriate therapy.
methodsIn a prospective study, we evaluated the clinical value of the AsperGenius polymerase chain reaction (PCR) assay in hematology patients from 12 centers. This PCR assay detects the most frequent cyp51A mutations in A. fumigatus conferring azole resistance. Patients were included when a computed tomography scan showed a pulmonary infiltrate and bronchoalveolar fluid (BALf) sampling was performed. The primary end point was antifungal treatment failure in patients with azole-resistant IA.
resultsOf 323 patients enrolled, complete mycological and radiological information was available for 276 (94%), and probable IA was diagnosed in 99/276 (36%). Sufficient BALf for PCR testing was available for 293/323 (91%). Aspergillus DNA was detected in 116/293 (40%) and A. fumigatus DNA in 89/293 (30%). The resistance PCR was conclusive in 58/89 (65%) and resistance detected in 8/58 (14%). Two had a mixed azole-susceptible/azole-resistant infection. In the 6 remaining patients, treatment failure was observed in 1. Galactomannan positivity was associated with mortality (P = .004) while an isolated positive Aspergillus PCR was not (P = .83).
conclusionsReal-time PCR-based resistance testing may help to limit the clinical impact of triazole resistance. In contrast, the clinical impact of an isolated positive Aspergillus PCR on BALf seems limited. The interpretation of the EORTC/MSGERC PCR criterion for BALf may need further specification (eg, minimum cycle threshold value and/or PCR positive on >1 BALf sample).
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