Samuel Fayemiwo1, Caroline B Moore2, Philip Foden3, David W Denning4, Malcolm D Richardson2. 1. Department of Medical Microbiology and Parasitology, College of Medicine, University of Ibadan, Ibadan, Nigeria; Mycology Reference Centre, University Hospital of South Manchester, Manchester Academic Health Sciences Centre, Manchester, UK; Institute of inflammation and Repair, Faculty of Medicine and Health Sciences, University of Manchester, UK. Electronic address: safayemiwo@comui.edu.ng. 2. Mycology Reference Centre, University Hospital of South Manchester, Manchester Academic Health Sciences Centre, Manchester, UK; Institute of inflammation and Repair, Faculty of Medicine and Health Sciences, University of Manchester, UK. 3. Medical Statistics Department, University Hospital of South Manchester, Manchester, UK. 4. Institute of inflammation and Repair, Faculty of Medicine and Health Sciences, University of Manchester, UK; National Aspergillosis Centre, University Hospital of South Manchester, Manchester Academic Health Sciences Centre, University of Manchester, UK.
Abstract
OBJECTIVES: Galactomannan (GM) and Aspergillus DNA detection are useful tools for the diagnosis of invasive pulmonary aspergillosis (IPA), primarily in blood and bronchoscopy samples. This study aimed to evaluate the utility of both markers for detection of Aspergillus in sputum from patients with allergic bronchopulmonary aspergillosis (ABPA) and chronic pulmonary aspergillosis (CPA). METHODS: ABPA or CPA demographic patient data were retrieved. This retrospective observational audit included 159 patients with at least one sputum pair. 223 sputum sample pairs were analysed, as well as six control samples for GM only. Real time PCR was performed following sputum DNA extraction using the MycAssay™ Aspergillus kit and cycle thresholds were subtracted from 38 to give positive values (transformed Ct, TCt). RESULTS: The mean age of the patients was 61.81years (SD: ±11.06; range 29-100). One hundred and twenty-six (79.2%) had CPA. Cultures were positive for fungi in 13.1% of the samples, and A. fumigatus was the commonest (11.9%) fungus isolated. Receiver operating characteristic (ROC curve) analysis of sputum GM comparing TCt of >0.0, and >2.0 to derive GMI cut-off values showed a cut-off of 6.5. About 50% of sputa with strongly positive PCR values had GM values>6.5. Two of six (33%) control samples had GM indices>6.5. CONCLUSION: It is not clear that GM determinations in sputum are useful for diagnosis of either CPA or ABPA, or following therapy. Crown
OBJECTIVES: Galactomannan (GM) and Aspergillus DNA detection are useful tools for the diagnosis of invasive pulmonary aspergillosis (IPA), primarily in blood and bronchoscopy samples. This study aimed to evaluate the utility of both markers for detection of Aspergillus in sputum from patients with allergic bronchopulmonary aspergillosis (ABPA) and chronic pulmonary aspergillosis (CPA). METHODS: ABPA or CPA demographic patient data were retrieved. This retrospective observational audit included 159 patients with at least one sputum pair. 223 sputum sample pairs were analysed, as well as six control samples for GM only. Real time PCR was performed following sputum DNA extraction using the MycAssay™ Aspergillus kit and cycle thresholds were subtracted from 38 to give positive values (transformed Ct, TCt). RESULTS: The mean age of the patients was 61.81years (SD: ±11.06; range 29-100). One hundred and twenty-six (79.2%) had CPA. Cultures were positive for fungi in 13.1% of the samples, and A. fumigatus was the commonest (11.9%) fungus isolated. Receiver operating characteristic (ROC curve) analysis of sputum GM comparing TCt of >0.0, and >2.0 to derive GMI cut-off values showed a cut-off of 6.5. About 50% of sputa with strongly positive PCR values had GM values>6.5. Two of six (33%) control samples had GM indices>6.5. CONCLUSION: It is not clear that GM determinations in sputum are useful for diagnosis of either CPA or ABPA, or following therapy. Crown
Authors: Elizabeth Stucky Hunter; Bayu Wilopo; Malcolm D Richardson; Chris Kosmidis; David W Denning Journal: Respir Med Date: 2021-01-12 Impact factor: 3.415
Authors: David W Denning; Iain D Page; Jeremiah Chakaya; Kauser Jabeen; Cecilia M Jude; Muriel Cornet; Ana Alastruey-Izquierdo; Felix Bongomin; Paul Bowyer; Arunaloke Chakrabarti; Sara Gago; John Guto; Bruno Hochhegger; Martin Hoenigl; Muhammad Irfan; Nicholas Irurhe; Koichi Izumikawa; Bruce Kirenga; Veronica Manduku; Samihah Moazam; Rita O Oladele; Malcolm D Richardson; Juan Luis Rodriguez Tudela; Anna Rozaliyani; Helmut J F Salzer; Richard Sawyer; Nasilele F Simukulwa; Alena Skrahina; Charlotte Sriruttan; Findra Setianingrum; Bayu A P Wilopo; Donald C Cole; Haileyesus Getahun Journal: Emerg Infect Dis Date: 2018-08 Impact factor: 6.883