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Published on: March 22, 2012
Invasive aspergillosis in two liver transplant recipients: diagnosis by SeptiFast
J Steinmann1, J Buer, P-M Rath
1Institute of Medical Microbiology, University Hospital Essen, Essen, Germany.
Abstract:
We report the clinical features, diagnosis, and monitoring findings of invasive aspergillosis (IA) in 2 liver transplant recipients. Blood/serum samples and bronchoalveolar lavage (BAL) fluids were analyzed by a novel commercial polymerase chain reaction (PCR) assay (SeptiFast) and an Aspergillus galactomannan (GM) enzyme-linked immunoassay (EIA). The diagnosis of IA could be performed in <6 h with the detection of Aspergillus fumigatus DNA in blood and BAL fluid. High GM values (mean: 9.1, range: 7.3-10.8) in serum and BAL fluid confirmed the SeptiFast result. Follow-up of the SeptiFast findings and GM index correlated with the clinical course. The molecular detection of A. fumigatus-specific DNA and GM test in blood/serum and BAL samples appears to be a useful tool for prompt diagnosis of IA. Further prospective clinical trials are necessary to evaluate the accuracy of SeptiFast and the GM test in diagnosing IA.
Insights
Rapid molecular detection of Aspergillus fumigatus DNA and galactomannan (GM) in transplant patients aids in early invasive aspergillosis (IA) diagnosis. These tests correlate with clinical outcomes, offering a valuable diagnostic tool.
Area of Science:
- Medical Mycology
- Transplant Infectious Diseases
- Molecular Diagnostics
Background:
- Invasive aspergillosis (IA) poses a significant threat to immunocompromised patients, particularly liver transplant recipients.
- Early and accurate diagnosis is crucial for effective treatment and improved patient outcomes.
Observation:
- This study evaluated a novel commercial polymerase chain reaction (PCR) assay (SeptiFast) and an Aspergillus galactomannan (GM) enzyme-linked immunoassay (EIA) in two liver transplant recipients with suspected IA.
- Samples analyzed included blood/serum and bronchoalveolar lavage (BAL) fluid.
Findings:
- The SeptiFast assay detected Aspergillus fumigatus DNA in blood and BAL fluid within 6 hours, enabling prompt diagnosis.
- High GM values in serum and BAL fluid corroborated the PCR findings.
- Monitoring of SeptiFast results and GM index correlated with the clinical progression of IA.
Implications:
- Molecular detection of Aspergillus DNA combined with GM testing offers a valuable approach for the rapid diagnosis of IA in transplant patients.
- Further prospective clinical trials are warranted to fully assess the accuracy and utility of these diagnostic methods.
