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

Mycoses. 2021 May 20. doi: 10.1111/myc.13319. Online ahead of print.

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.

PMID:34013523 | DOI:10.1111/myc.13319

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