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Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
08:01

Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology

Published on: March 22, 2012

Aspergillus sp. isolated in critically ill patients with extracorporeal membrane oxygenation support

Cecile Aubron1, David Pilcher, Tim Leong

  • 1Intensive Care Unit, Alfred Hospital, Melbourne, Australia. cecile.aubron@monash.edu

Scandinavian Journal of Infectious Diseases
|June 11, 2013
PubMed

Insights

Aspergillus isolation occurred in 7.2% of critically ill patients on extracorporeal membrane oxygenation (ECMO). Diagnosis of invasive aspergillosis remains challenging in this population, necessitating improved non-invasive methods.

Area of Science:

  • Critical Care Medicine
  • Mycology
  • Infectious Diseases

Background:

  • Aspergillus isolation in critically ill patients on extracorporeal membrane oxygenation (ECMO) presents diagnostic challenges.
  • Establishing a definitive diagnosis of aspergillosis in this specific patient group is complex.

Purpose of the Study:

  • To report the incidence of Aspergillus isolation in patients undergoing ECMO.
  • To evaluate the utility of modified European Organization for Research and Treatment of Cancer and Mycoses Study Group (EORTC/MSG) criteria for diagnosing aspergillosis in ECMO patients.
  • To highlight the difficulties in diagnosing invasive aspergillosis in this population.

Main Methods:

  • Retrospective analysis of 151 patients who underwent ECMO between 2005 and 2011.
  • Application of modified EORTC/MSG criteria adapted for critically ill patients to diagnose Aspergillus infection or colonization.
  • Review of clinical data and Aspergillus isolates from pulmonary and wound samples.

Main Results:

  • Aspergillus species were isolated in 11 of 151 ECMO patients (7.2%).
  • Isolates were predominantly pulmonary (10 patients), with one from a mediastinal wound.
  • Diagnoses ranged from proven invasive pulmonary aspergillosis (IPA) to colonization, with 5 patients lacking classical risk factors.

Conclusions:

  • The clinical relevance of Aspergillus isolation in ECMO patients requires careful interpretation, as current diagnostic algorithms may not be validated for this group.
  • The study underscores the need for developing and implementing non-invasive diagnostic procedures for aspergillosis in critically ill patients on ECMO.
  • Further research is needed to refine diagnostic strategies for fungal infections in ECMO patients.

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