Your browser doesn't support javascript.
Systematic screening for COVID-19 associated invasive aspergillosis in ICU patients by culture and PCR on tracheal aspirate.
van Grootveld, Rebecca; van Paassen, Judith; de Boer, Mark G J; Claas, Eric C J; Kuijper, Ed J; van der Beek, Martha T.
  • van Grootveld R; Department of Medical Microbiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands.
  • van Paassen J; Department of Intensive Care, LUMC, Leiden, The Netherlands.
  • de Boer MGJ; Department of Infectious Diseases, LUMC, Leiden, The Netherlands.
  • Claas ECJ; Department of Medical Microbiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands.
  • Kuijper EJ; Department of Medical Microbiology, LUMC & Centre for Infectious Diseases Research, Diagnostics and Laboratory Surveillance, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
  • van der Beek MT; Department of Medical Microbiology, LUMC, and the LUMC-COVID-19 Research Group, Leiden, The Netherlands.
Mycoses ; 64(6): 641-650, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1091024
Semantic information from SemMedBD (by NLM)
1. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
2. Polymerase Chain Reaction METHOD_OF Screening procedure
Subject
Polymerase Chain Reaction
Predicate
METHOD_OF
Object
Screening procedure
3. Respiratory sample PART_OF Patients
Subject
Respiratory sample
Predicate
PART_OF
Object
Patients
4. Structure of upper respiratory tract cavity LOCATION_OF Colonization
Subject
Structure of upper respiratory tract cavity
Predicate
LOCATION_OF
Object
Colonization
5. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
6. Polymerase Chain Reaction METHOD_OF Screening procedure
Subject
Polymerase Chain Reaction
Predicate
METHOD_OF
Object
Screening procedure
7. Respiratory sample PART_OF Patients
Subject
Respiratory sample
Predicate
PART_OF
Object
Patients
8. Structure of upper respiratory tract cavity LOCATION_OF Colonization
Subject
Structure of upper respiratory tract cavity
Predicate
LOCATION_OF
Object
Colonization
ABSTRACT

BACKGROUND:

A high prevalence of COVID-19 associated pulmonary aspergillosis (CAPA) has been reported, though histopathological evidence is frequently lacking. To assess the clinical significance of Aspergillus species in respiratory samples of mechanically ventilated COVID-19 patients, we implemented routine screening for Aspergillus in tracheal aspirate (TA). PATIENTS/

METHODS:

From all adult COVID-19 patients admitted to the intensive care unit (ICU), TA samples were collected twice a week for Aspergillus screening by PCR and or culture. Bronchoalveolar lavage (BAL) sampling was performed in patients with a positive screening result if possible. Clinical information was obtained from the electronic patient record and patients were categorised according to the recently published consensus case definition for CAPA.

RESULTS:

Our study population consisted of 63 predominantly (73%) male patients, with a median age of 62 years and total median ICU stay of 18 days. Aspergillus species were present in TA screening samples from 15 patients (24%), and probable CAPA was diagnosed in 11 (17%) patients. Triazole resistance was detected in one patient (14%). Concordance between TA and BAL was 86%, and all TA culture positives were confirmed in BAL. We were able to withhold treatment in three of fifteen patients with positive screening (20%) but negative BAL results.

CONCLUSIONS:

Positive culture, molecular detection and or antigen detection of Aspergillus species do not equal infection. Until we understand the clinical relevance of Aspergillus species detected in respiratory samples of COVID-19 patients, minimal-invasive screening by TA is a feasible method to monitor patients. Positive screening results should be an indication to perform a BAL to rule out upper airway colonisation.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Invasive Pulmonary Aspergillosis / COVID-19 Testing / COVID-19 Type of study: Diagnostic study / Risk factors / Screening study Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Mycoses Journal subject: Microbiology Year: 2021 Document Type: Article Affiliation country: Myc.13259

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Invasive Pulmonary Aspergillosis / COVID-19 Testing / COVID-19 Type of study: Diagnostic study / Risk factors / Screening study Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Mycoses Journal subject: Microbiology Year: 2021 Document Type: Article Affiliation country: Myc.13259