title: The performance of real-time PCR, galactomannan, and fungal culture in the diagnosis of invasive aspergillosis in ventilated patients with chronic obstructive pulmonary disease (COPD).
abstract: Emerging reports have associated chronic pulmonary obstructive disease (COPD) with invasive aspergillosis (IA), particularly in patients treated with mechanical ventilation and/or corticosteroids. This is a multicentre study in which COPD patients demonstrating a new lung infiltrate while being mechanically ventilated were prospectively evaluated for the presence of IA. From the 47 patients studied, Aspergillus fumigatus was recovered in culture in two patients (4.2%). While serum galactomannan (GM) was negative for 94% of patients, GM levels in respiratory samples were >0.5, >1.0 and >1.5 for 74.5, 40.5, and 21.3% of patients, respectively. PCR was positive for 10 patients in the study but did not differentiate Aspergillus colonization from infection. The combination of PCR and GM in respiratory samples may be an interesting alternative to diagnose IA in COPD patients.
authors.affiliation: Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Valério R
authors.initials: VR
authors.lastname: Aquino
authors.forename: Fabiano
authors.initials: F
authors.lastname: Nagel
authors.forename: Huander F
authors.initials: HF
authors.lastname: Andreolla
authors.forename: Fernanda
authors.initials: F
authors.lastname: de-Paris
authors.forename: Melissa O
authors.initials: MO
authors.lastname: Xavier
authors.forename: Luciano Z
authors.initials: LZ
authors.lastname: Goldani
authors.forename: David W
authors.initials: DW
authors.lastname: Denning
authors.forename: Alessandro C
authors.initials: AC
authors.lastname: Pasqualotto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001232:Aspergillus fumigatus / Q000254:growth & development* / Q000302:isolation & purification*; D015331:Cohort Studies; D005260:Female; D005690:Galactose / Q000031:analogs & derivatives; D006801:Humans; D055744:Invasive Pulmonary Aspergillosis / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008351:Mannans / Q000032:analysis*; D008828:Microbiological Techniques / Q000379:methods*; D008875:Middle Aged; D009172:Mycology / Q000379:methods*; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods*
chemical_list: D008351:Mannans; C012990:galactomannan; D005690:Galactose