Performance of the AsperGenius® PCR assay for detecting azole resistant Aspergillus fumigatus in BAL fluids from allogeneic HSCT recipients: A prospective cohort study from Essen, West Germany

Bw, Pelzer; Seufert, R.; Koldehoff, Michael; Liebregts, Tobias; Schmidt, Dirk; Buer, Jan; Pm, Rath; Steinmann, Joerg

doi:10.1093/mmy/myz050

Cited by 12 publications

(14 citation statements)

References 15 publications

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“…We found only one azole-resistant A. fumigatus isolate, which was successfully detected in each of the PCR assays. Regarding the detection of mutations in the cyp51A gene, MycoGENIE ® and AsperGenius ® assay worked reliably in various studies [25,[27][28][29]. Furthermore, the detection of mixed infections with azole-resistant and susceptible A. fumigatus isolates was possible with AsperGenius ® , while cultures were negative [33].…”

Section: Discussionmentioning

confidence: 95%

“…Samples were collected from 2015 to 2017, and 23 probable cases were identified [28]. Sensitivity was 65%, specificity and PPV 100% and NPV 91% for probable IPA group [28]. Other study groups detected sensitivity about 84% and specificity between 80% and 91.4%, PPV between 76% and 84% and NPV between 87% and 94.6%, respectively [18,29].…”

Section: Discussionmentioning

confidence: 99%

“…In a previous study, our group tested the performance of AsperGenius ® on 100 consecutive allogenic haematopoietic stem cell transplant recipients [28]. Samples were collected from 2015 to 2017, and 23 probable cases were identified [28]. Sensitivity was 65%, specificity and PPV 100% and NPV 91% for probable IPA group [28].…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of Three Commercial PCR Assays for the Detection of Azole-Resistant Aspergillus fumigatus from Respiratory Samples of Immunocompromised Patients

Scharmann

Kirchhoff

Hain

et al. 2021

JoF

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This is the first study comparing three commercially available PCR assays for the detection of Aspergillus DNA from respiratory specimen of immunocompromised patients and the presence of cyp51A gene mutations. Bronchoalveolar lavages (BALs, N = 103) from patients with haematological/oncological underlying diseases were retrospectively investigated. The performance of three PCR assays, namely MycoGENIE®Aspergillus fumigatus Real-Time PCR Kit (Adamtech), Fungiplex®Aspergillus Azole-R IVD Real-Time PCR Kit (Bruker Daltonik GmbH) and AsperGenius® (PathoNostics B.V.), were evaluated. All patients were categorised following current EORTC/MSG criteria, with exclusion of the PCR-results. From the 11 invasive pulmonary aspergillosis (IPA) probable samples, eight were detected with MycoGENIE®, resulting in a sensitivity of 80% and a specificity of 73%. Furthermore, Fungiplex® resulted in six positive BALs with a sensitivity of 60% and a specificity of 91% and AsperGenius® in seven positive BAL samples, with a sensitivity of 64% and a specificity of 97%. No proven IPA was detected. One isolate showed phenotypically an azole-resistance, which was also detected in each of the tested PCR assays with the mutation in TR34. The here tested PCR assays were capable of reliably detecting A. fumigatus DNA, as well as differentiation of the common cyp51A gene mutations. However, evaluation on the AsperGenius® assay revealed a low risk of false positive results.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

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Evaluation of Three Commercial PCR Assays for the Detection of Azole-Resistant Aspergillus fumigatus from Respiratory Samples of Immunocompromised Patients

Scharmann

Kirchhoff

Hain

et al. 2021

JoF

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“…The first panel identifies aspergillosis caused by A. fumigatus , Aspergillus terreus, and Aspergillus spp. [ 59 , 60 ]. This test was evaluated clinically with good results in serum (sensitivity > 78% and specificity of 100% for species with a limit of detection >10 genomic units of A. fumigatus ) [ 60 ], plasma (80% sensitivity and >77% specificity) [ 61 ], and in broncoalveolar lavage (BAL) (>80% sensitivity and >90% specificity for hematological and ICU patients) [ 62 , 63 ].…”

Section: Intrinsic Resistance Detectionmentioning

confidence: 99%

“…[ 59 , 60 ]. This test was evaluated clinically with good results in serum (sensitivity > 78% and specificity of 100% for species with a limit of detection >10 genomic units of A. fumigatus ) [ 60 ], plasma (80% sensitivity and >77% specificity) [ 61 ], and in broncoalveolar lavage (BAL) (>80% sensitivity and >90% specificity for hematological and ICU patients) [ 62 , 63 ]. The biggest advantage of this diagnostic kit is its ability to detect the intrinsic amphotericin B resistant A. terreus and the fact that it has no false-negative results for aspergillosis caused by non- A. fumigatus and non- A. terreus (other available kits are able to detect only A. fumigatus ) [ 64 ].…”

Section: Intrinsic Resistance Detectionmentioning

confidence: 99%

Molecular Markers of Antifungal Resistance: Potential Uses in Routine Practice and Future Perspectives

García‐Effrón

2021

JoF

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Antifungal susceptibility testing (AST) has come to establish itself as a mandatory routine in clinical practice. At the same time, the mycological diagnosis seems to have headed in the direction of non-culture-based methodologies. The downside of these developments is that the strains that cause these infections are not able to be studied for their sensitivity to antifungals. Therefore, at present, the mycological diagnosis is correctly based on laboratory evidence, but the antifungal treatment is undergoing a growing tendency to revert back to being empirical, as it was in the last century. One of the explored options to circumvent these problems is to couple non-cultured based diagnostics with molecular-based detection of intrinsically resistant organisms and the identification of molecular mechanisms of resistance (secondary resistance). The aim of this work is to review the available molecular tools for antifungal resistance detection, their limitations, and their advantages. A comprehensive description of commercially available and in-house methods is included. In addition, gaps in the development of these molecular technologies are discussed.

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Emerging Challenges in Diagnosis and Treatment of Invasive Fungal Infections: Addressing the Impact of COVID-19 and New Pathogens

Ahmadi,

Bashardoust,

Abdorahimi

et al. 2023

Curr Fungal Infect Rep

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Performance of the AsperGenius® PCR assay for detecting azole resistant Aspergillus fumigatus in BAL fluids from allogeneic HSCT recipients: A prospective cohort study from Essen, West Germany

Cited by 12 publications

References 15 publications

Evaluation of Three Commercial PCR Assays for the Detection of Azole-Resistant Aspergillus fumigatus from Respiratory Samples of Immunocompromised Patients

Evaluation of Three Commercial PCR Assays for the Detection of Azole-Resistant Aspergillus fumigatus from Respiratory Samples of Immunocompromised Patients

Molecular Markers of Antifungal Resistance: Potential Uses in Routine Practice and Future Perspectives

Emerging Challenges in Diagnosis and Treatment of Invasive Fungal Infections: Addressing the Impact of COVID-19 and New Pathogens

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