Use of PCR for diagnosis of invasive aspergillosis: systematic review and meta-analysis

Mengoli, Carlo; Cruciani, Mario; Barnes, Rosemary Ann; Loeffler, Juergen; Donnelly, J. Peter

doi:10.1016/s1473-3099(09)70019-2

Cited by 313 publications

(199 citation statements)

References 47 publications

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“…The specificity was generally lower, but could be significantly improved by establishing the requirement of two consecutive positive PCR results as a diagnostic criterion. 29,30 However, the diagnostic reliability of PCR assays in peripheral blood and serum specimens has been described to be rather limited. 31,32 The panfungal real-time PCR assay presented was specifically adapted to highly sensitive detection of fungal pathogens in peripheral blood or serum.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of invasive fungal infections by a real-time panfungal PCR assay in immunocompromised pediatric patients

Landlinger¹,

Preuner²,

Bašková³

et al. 2010

Leukemia

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Invasive fungal disease (IFD) is a life-threatening event in immunocompromised patients, and there is an urgent need for reliable screening methods facilitating rapid and broad detection of pathogenic fungi. We have established a two-reaction real-time PCR assay permitting highly sensitive detection of more than 80 fungal pathogens, covering a large spectrum of moulds, yeasts and Zygomycetes. To assess the clinical potential of the assay, more than 600 consecutive specimens from 125 pediatric patients carrying a high risk of IFD were analyzed. An excellent correlation between PCR positivity and the presence of proven, probable or possible fungal infection according to the European Organization for Research and Treatment of Cancer criteria was demonstrated, as revealed by the sensitivity of the assay of 96% (95% CI: 82-99%). The negative predictive value of the panfungal PCR assay presented was 98% (95% CI: 90-100%), while the specificity and the positive predictive value were 77% (95% CI: 66-85%) and 62% (95% CI: 47-75%), respectively. The results indicate that molecular screening of patients during febrile neutropenic episodes by the assay presented could help prevent unnecessary toxicity resulting from empirical antifungal treatment in individuals who may not be at risk of imminent fungal disease. Our observations raise the possibility that rapid species identification may be required to increase the positive predictive value for impending fungus-related disease.

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Section: Discussionmentioning

confidence: 99%

Diagnosis of invasive fungal infections by a real-time panfungal PCR assay in immunocompromised pediatric patients

Landlinger¹,

Preuner²,

Bašková³

et al. 2010

Leukemia

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“…59 A recent meta-analysis of studies in hematological patients with IA using different home-made PCRs in blood reported a sensitivity of 75% (95% CI: 54-88) and a specificity of 87% (95% CI: 78-93) for two PCR-positive results, and a sensitivity of 88% (95% CI: 75-95) and a specificity of 75% (95% CI: 63-84) for a single positive result. 60 When used as a screening test, authors favor the negative predictive value of the results. 61,62 For the diagnosis of IA using PCR in BAL fluids, another meta-analysis calculated a mean sensitivity of 79% (95% CI: 72.8-83.1) and a mean specificity of 94% (95% CI: 92.1-95.0).…”

Section: Pcr For the Diagnosis Of Iamentioning

confidence: 99%

ECIL recommendations for the use of biological markers for the diagnosis of invasive fungal diseases in leukemic patients and hematopoietic SCT recipients

Marchetti

Lamoth

Mikulska

et al. 2011

Bone Marrow Transplant

237

172

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“…Development of tests not based on cultures, such as the galactomannan assay (GM assay), (1R3)-b-D-glucan assay (G assay) and PCR has received significant attention from researchers. Meta-analyses have shown a sensitivity of 0.78, 0.77 and 0.75 and a specificity of 0.81, 0.83 and 0.87 for the GM assay, G assay and PCR, respectively, using serum (Leeflang et al, 2008;Mengoli et al, 2009;Onishi et al, 2012). Despite their wide usage, these tests have limitations, such as time and equipment requirements as well as the occurrence of significant performance variation.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of a novel lateral-flow device in invasive aspergillosis: a meta-analysis

Pan

Zhang

et al. 2015

Journal of Medical Microbiology

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A novel lateral-flow device (LFD) has been invented for use as a diagnostic tool for invasive aspergillosis (IA). We conducted a meta-analysis to assess the diagnostic accuracy of the device. Published studies that used the European Organization for Research and Treatment of Cancer/Mycoses Study Group criteria and provided sufficient data were included. Two reviewers independently collected the data from each study and assessed the risk bias using the Quality Assessment of Diagnostic Accuracy Studies-2. The pooled sensitivity, specificity and diagnostic odds ratio (DOR) were computed and reported with a 95 % confidence interval 90 (95 % CI,) in the LFD test using serum. We concluded that the Aspergillus LFD had a good diagnostic value in immunocompromised patients at risk of IA. The BAL LFD might have a better performance than the serum LFD test.

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Use of PCR for diagnosis of invasive aspergillosis: systematic review and meta-analysis

Cited by 313 publications

References 47 publications

Diagnosis of invasive fungal infections by a real-time panfungal PCR assay in immunocompromised pediatric patients

Diagnosis of invasive fungal infections by a real-time panfungal PCR assay in immunocompromised pediatric patients

ECIL recommendations for the use of biological markers for the diagnosis of invasive fungal diseases in leukemic patients and hematopoietic SCT recipients

Diagnostic accuracy of a novel lateral-flow device in invasive aspergillosis: a meta-analysis

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