Quantitative Real-Time PCR and Platelia Galactomannan Assay for the Diagnosis of Invasive Pulmonary Aspergillosis: Bronchoalveolar Lavage Fluid Performs Better Than Serum in Non-neutropaenic Patients.
The diagnosis of invasive pulmonary aspergillosis (IPA) is still in challenge in clinical practice, particularly for those patients without an obvious neutropaenia. In this study, a well-validated qPCR method and Platelia galactomannan (GM) assay were compared for their diagnostic performance using paired samples of bronchoalveolar lavage (BAL) fluid and serum from predominantly non-neutropaenic patients. In the serum samples, qPCR showed a comparable performance with GM assay in terms of sensitivity and specificity. In the BAL samples, qPCR and GM assay both demonstrated a good sensitivity (90 vs. 90 %); however, the specificity of qPCR was higher than that of GM assay (92.5 vs. 68.8 %, P < 0.001) in these samples. A better sensitivity was obtained with BAL compared with serum samples for both GM assay (90 vs. 50 %) and qPCR (90 vs. 60 %). In conclusion, in non-neutropaenic patients, BAL appears to provide improved sensitivity for both GM and qPCR assays. BAL qPCR offers a better diagnostic value for IPA compared with BAL GM assay, significantly increasing the specificity without affecting the sensitivity.
Research Center for Medical Mycology, Department of Dermatology and Venereology, Peking University First Hospital, Peking University, Beijing, 100034, China.|Beijing Key Laboratory of Molecular Diagnosis of Dermatoses, Beijing, China.
Shuzhen
S
Zhang
Research Center for Medical Mycology, Department of Dermatology and Venereology, Peking University First Hospital, Peking University, Beijing, 100034, China.|Beijing Key Laboratory of Molecular Diagnosis of Dermatoses, Beijing, China.
Sibu
S
Wang
Research Center for Medical Mycology, Department of Dermatology and Venereology, Peking University First Hospital, Peking University, Beijing, 100034, China.|Beijing Key Laboratory of Molecular Diagnosis of Dermatoses, Beijing, China.
Zhe
Z
Wan
Department of Respiratory, Peking University First Hospital, Beijing, China.
Chengli
C
Que
Research Center for Medical Mycology, Department of Dermatology and Venereology, Peking University First Hospital, Peking University, Beijing, 100034, China.|Beijing Key Laboratory of Molecular Diagnosis of Dermatoses, Beijing, China.
Ruoyu
R
Li
Research Center for Medical Mycology, Department of Dermatology and Venereology, Peking University First Hospital, Peking University, Beijing, 100034, China. yujin676@126.com.|Beijing Key Laboratory of Molecular Diagnosis of Dermatoses, Beijing, China. yujin676@126.com.
Jin
J
Yu
D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry* / Q000382:microbiology*; D004271:DNA, Fungal / Q000032:analysis* / Q000235:genetics; D003955:Diagnostic Tests, Routine / Q000379:methods; D005690:Galactose / Q000031:analogs & derivatives; D006801:Humans; D007118:Immunoassay / Q000379:methods*; D055744:Invasive Pulmonary Aspergillosis / Q000175:diagnosis*; D008351:Mannans / Q000032:analysis*; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D044967:Serum / Q000737:chemistry / Q000382:microbiology
D004271:DNA, Fungal; D008351:Mannans; C012990:galactomannan; D005690:Galactose
Bronchoalveolar lavage fluid; Galactomannan; Invasive pulmonary aspergillosis; Serum; qPCR