Diagnosing and monitoring of invasive aspergillosis during antifungal therapy by polymerase chain reaction: an experimental study in mice.
This study evaluated the value of polymerase chain reaction (PCR) for diagnosing and monitoring of invasive aspergillosis during amphotericin B therapy. PCR, microscopy and culture of tissues samples (n = 126) and blood samples (n = 78) of experimentally infected mice (n = 42) were performed. The PCR results of treated were compared to those of untreated animals; Aspergillus fumigatus and A. terreus were used in this study. In the amphotericin B treated group the sensitivities of PCR, microscopic examination and culture of the various tissues were 69, 58, and 53%, respectively; the specificities of all examinations were 100%. In the untreated group the sensitivities of PCR, microscopic examination, and culture were 72, 64, and 57%, respectively; the specificities of all examinations were 100%. The 78 blood samples taken from mice under therapy were tested by PCR over a period of 8 days following Aspergillus infection. The test sensitivity was 77%, the specificity 46%, the positive predictive value 59%, and the negative predictive value 67%. In the untreated group the sensitivity was 92%, the specificity 46%, the positive predictive value 63%, and the negative predictive value 86%. The results suggest that this PCR method has possible clinical value for improving the diagnosis of invasive Aspergillus infection. Monitoring of blood under antifungal therapy is not recommended.
Lass-Flörl
Cornelia
C
Department of Hygiene and Social Medicine, University of Innsbruck, Fritz Pregl Str.3, 6020 Innsbruck, Austria. Cornelia.Lass-Floerl@uibk.ac.at
Speth
Cornelia
C
Mayr
Astrid
A
Würzner
Reinhard
R
Dierich
Manfred P
MP
Ulmer
Hanno
H
Dietrich
Hermann
H
D000666:Amphotericin B / Q000494:pharmacology*; D000818:Animals; D000935:Antifungal Agents / Q000494:pharmacology; D001228:Aspergillosis / Q000175:diagnosis* / Q000188:drug therapy*; D004271:DNA, Fungal / Q000032:analysis; D004195:Disease Models, Animal; D005260:Female; D016469:Fungemia / Q000175:diagnosis* / Q000188:drug therapy*; D051379:Mice; D008807:Mice, Inbred BALB C; D016133:Polymerase Chain Reaction / Q000379:methods*; D012016:Reference Values; D012680:Sensitivity and Specificity
D000935:Antifungal Agents; D004271:DNA, Fungal; D000666:Amphotericin B