Aspergillus PCR: One step closer to standardization

White, P. Lewis, Bretagne, Stephane, Klingspor, Lena, Melchers, Willem J. G., McCulloch, Elaine, Schulz, Bettina, Finnstrom, Niklas, Mengoli, Carlo, Barnes, Rosemary Ann, Donnelly, J. Peter and Loeffler, Juergen 2010. Aspergillus PCR: One step closer to standardization. Journal of Clinical Microbiology 48 (4) , pp. 1231-1240. 10.1128/JCM.01767-09

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Abstract

PCR has been used as an aid in the diagnosis of invasive aspergillosis for almost 2 decades. A lack of standardization has limited both its acceptance as a diagnostic tool and multicenter clinical evaluations, preventing its inclusion in disease-defining criteria. In 2006, the European Aspergillus PCR Initiative was formed. The aim of the initiative was to provide optimal standardized protocols for the widespread clinical evaluation of the Aspergillus PCR to determine its diagnostic role and allow inclusion in disease diagnosis criteria. Quality control panels were developed and circulated to centers for evaluation of the existing methodology before recommendations based on the initial results were proposed for further panels. The centers were anonymously classified as “compliant” or “noncompliant,” according to whether they had followed the proposed recommendations before the performance parameters were determined and meta-regression analysis was performed. Most PCR amplification systems provided similar detection thresholds, although positivity was a function of the fungal burden. When PCR amplification was combined with DNA extraction, 50% of the centers failed to achieve the same level of detection. Meta-regression analysis showed positive correlations between sensitivity and extraction protocols incorporating the proposed recommendations and the use of bead beating, white cell lysis buffer, and an internal control PCR. The use of elution volumes above 100 μl showed a negative correlation with sensitivity. The efficiency of the Aspergillus PCR is limited by the extraction procedure and not by PCR amplification. For PCR testing of whole blood, it is essential that large blood volumes (≥3 ml) be efficiently lysed before bead beating to disrupt the fungal cell and performance of an internal control PCR to exclude false negativity. DNA should be eluted in volumes of <100 μl.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Subjects:	Q Science > QR Microbiology
Additional Information:	Pdf uploaded in accordance with publisher's policy at http://www.sherpa.ac.uk/romeo/issn/0095-1137/ (accessed 25/02/2014)
Publisher:	American Society for Microbiology
ISSN:	0095-1137
Date of First Compliant Deposit:	30 March 2016
Last Modified:	05 May 2023 14:03
URI:	https://orca.cardiff.ac.uk/id/eprint/27425

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