Aspergillus-PCR in bronchoalveolar lavage - diagnostic accuracy for invasive pulmonary aspergillosis in critically ill patients.
Mycoses
; 65(4): 411-418, 2022 Apr.
Article
in English
| MEDLINE | ID: covidwho-1685386
ABSTRACT
BACKGROUND:
The diagnosis of invasive pulmonary aspergillosis (IPA) in intensive care unit (ICU) patients is challenging, and the role of Aspergillus-PCR in bronchoalveolar lavage (BAL) is unknown.OBJECTIVES:
This study evaluated diagnostic accuracy of Aspergillus-PCR in BAL in IPA in three different cohorts ICU-admitted patients with COVID-19, ICU-admitted patients without COVID-19 and immunocompromised patients.METHODS:
All stored available BAL samples collected from three patient groups were tested with Aspergillus-PCR (AsperGenius® ). IPA was diagnosed according to appropriate criteria for each patient group.RESULTS:
We included 111 BAL samples from 101 patients 52 (51%) patients admitted to ICU for COVID-19, 24 (24%) admitted to ICU for other reasons and 25 (25%) immunocompromised. There were 31 cases of IPA (28%). Aspergillus-PCR sensitivity was 64% (95% CI 47-79) and specificity 99% (95% CI 93-100). Aspergillus-PCR sensitivity was 40% (95%CI 19-64) in ICU COVID-19, 67% (95% CI 21-93) in non-COVID-19 ICU patients and 92% (95%CI 67-98) in the immunocompromised. The concordance between positive BAL-GM and BAL-PCR in patients with and without IPA was significantly lower in ICU patients (32%; 43% in COVID-19, 18% in non-COVID-19) than in the immunocompromised (92%), p < .001.CONCLUSIONS:
Aspergillus-PCR in BAL improves the diagnostic accuracy of BAL-GM in ICU patients.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Invasive Pulmonary Aspergillosis
/
COVID-19
Type of study:
Cohort study
/
Diagnostic study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Humans
Language:
English
Journal:
Mycoses
Journal subject:
Microbiology
Year:
2022
Document Type:
Article
Affiliation country:
Myc.13428
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