Clinical performance of Aspergillus PCR for testing serum and plasma: a study by the European Aspergillus PCR Initiative

White, P. Lewis, Barnes, Rosemary Ann, Springer, Jan, Klingspor, Lena, Cuenca-Estrella, Manuel, Morton, C. Oliver, Lagrou, Katrien, Bretagne, Stephane, Melchers, Willem J. G., Mengoli, Carlo, Donnelly, J. Peter, Heinz, Werner J. and Loeffler, Juergen 2015. Clinical performance of Aspergillus PCR for testing serum and plasma: a study by the European Aspergillus PCR Initiative. Journal of Clinical Microbiology 53 (9) , pp. 2832-2837. 10.1128/JCM.00905-15

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Abstract

Aspergillus PCR testing of serum provides technical simplicity, but with potentially reduced sensitivity compared to whole blood testing. For a disease where screening to exclude disease provides an optimal strategy sensitivity is paramount. The associated analytical study confirmed that DNA concentrations were greater in plasma compared to serum. The aim of this current investigation was to confirm the analytical findings by comparing the performance of Aspergillus PCR testing of plasma and serum in the clinical setting. Standardised Aspergillus PCR was performed on plasma and serum samples concurrently obtained from haematology patients, as a multi-centre retrospective anonymous case-control study with cases diagnosed according to EORTC/MSG consensus definitions (19 proven/probable cases and 42 controls). Clinical performance and clinical utility (time to positivity) were calculated for both samples. The sensitivity and specificity for Aspergillus PCR when testing serum were 68.4% and 76.2%, and plasma were 94.7% and 83.3%, respectively. Eighty-five percent of serum and plasma PCR results were concordant. On average plasma PCR was positive 16.8 days before diagnosis and was the earliest indicator of infection in 13 cases, combined with other biomarkers in five cases. On average serum PCR was positive 10.8 days before diagnosis and was the earliest indicator of infection in six cases, combined with other biomarkers in three cases. Summary: These results confirm the analytical finding that sensitivity of Aspergillus PCR using plasma is superior to that of serum. PCR positivity occurs earlier when testing plasma and provides sufficient sensitivity for screening of invasive aspergillosis, while maintaining methodological simplicity.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Subjects:	Q Science > QR Microbiology
Additional Information:	Available online 17 June 2015
Publisher:	American Society for Microbiology
ISSN:	0095-1137
Date of First Compliant Deposit:	30 March 2016
Date of Acceptance:	12 June 2015
Last Modified:	05 May 2023 10:31
URI:	https://orca.cardiff.ac.uk/id/eprint/84235

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