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Updated: Aug 8, 2026
Detection of Invasive Pulmonary Aspergillosis in Haematological Malignancy Patients by using Lateral-flow Technology
Published on: March 22, 2012
Identification of invasive fungal diseases in immunocompromised patients by combining an Aspergillus specific PCR
T Boch1, M Reinwald1, P Postina1
1Department of Hematology and Oncology, University Hospital Mannheim, University of Heidelberg, Mannheim, Germany.
Abstract:
The increasing incidence of invasive fungal diseases (IFD), most of all invasive aspergillosis (IA) in immunocompromised patients emphasises the need to improve the diagnostic tools for detection of fungal pathogens. We investigated the diagnostic performance of a multifungal DNA-microarray detecting 15 different fungi [Aspergillus, Candida, Fusarium, Mucor, Rhizopus, Scedosporium and Trichosporon species (spp.)] in addition to an Aspergillus specific polymerase chain reaction (PCR) assay. Biopsies, bronchoalveolar lavage and peripheral blood samples of 133 immunocompromised patients (pts) were investigated by a multifungal DNA-microarray as well as a nested Aspergillus specific PCR assay. Patients had proven (n = 18), probable (n = 29), possible (n = 48) and no IFD (n = 38) and were mostly under antifungal therapy at the time of sampling. The results were compared to culture, histopathology, imaging and serology, respectively. For the non-Aspergillus IFD the microarray analysis yielded in all samples a sensitivity of 64% and a specificity of 80%. Best results for the detection of all IFD were achieved by combining DNA-microarray and Aspergillus specific PCR in biopsy samples (sensitivity 79%; specificity 71%). The molecular assays in combination identify genomic DNA of fungal pathogens and may improve identification of causative pathogens of IFD and help overcoming the diagnostic uncertainty of culture and/or histopathology findings, even during antifungal therapy.
Insights
Diagnosing invasive fungal diseases (IFD) in immunocompromised patients is challenging. Combining DNA-microarray and Aspergillus PCR improves detection of fungal pathogens, even during antifungal therapy.
Area of Science:
- Medical Mycology
- Molecular Diagnostics
- Infectious Diseases
Background:
- Invasive fungal diseases (IFD) pose a significant threat to immunocompromised patients.
- Accurate and timely diagnosis of IFD is crucial for effective treatment.
- Current diagnostic methods like culture and histopathology have limitations, especially during antifungal therapy.
Purpose of the Study:
- To evaluate the diagnostic performance of a multifungal DNA-microarray and an Aspergillus-specific PCR assay for detecting fungal pathogens.
- To assess the combined diagnostic utility of these molecular methods in immunocompromised patients.
- To compare molecular methods with conventional diagnostic techniques.
Main Methods:
- Investigated 133 immunocompromised patients with suspected IFD.
- Utilized a multifungal DNA-microarray capable of detecting 15 fungal species.
- Employed a nested Aspergillus-specific PCR assay.
- Analyzed biopsies, bronchoalveolar lavage, and peripheral blood samples.
- Compared results with culture, histopathology, imaging, and serology.
Main Results:
- The DNA-microarray showed 64% sensitivity and 80% specificity for non-Aspergillus IFD.
- Combining DNA-microarray and Aspergillus PCR in biopsy samples achieved 79% sensitivity and 71% specificity for all IFD.
- Molecular assays identified fungal genomic DNA, aiding pathogen identification.
Conclusions:
- Molecular assays, particularly the combination of DNA-microarray and Aspergillus PCR, offer improved diagnostic capabilities for IFD.
- These methods can overcome diagnostic uncertainties associated with conventional techniques, even during antifungal treatment.
- Enhanced detection of fungal pathogens can lead to better patient management and outcomes.
