The impact of anti-mould prophylaxis on Aspergillus PCR blood
testing for the diagnosis of invasive aspergillosis.

J 2021

The impact of anti-mould prophylaxis on Aspergillus PCR blood testing for the diagnosis of invasive aspergillosis.

CRUCIANI, M., P. L. WHITE, C. MENGOLI, J. LÖFFLER, C. O. MORTON et. al.

Základní údaje

Originální název

The impact of anti-mould prophylaxis on Aspergillus PCR blood testing for the diagnosis of invasive aspergillosis.

Autoři

CRUCIANI, M., P. L. WHITE (garant), C. MENGOLI, J. LÖFFLER, C. O. MORTON, L. KLINGSPOR, D. BUCHHEIDT, J. MAERTENS, W. J. HEINZ, T. R. ROGERS, Barbora WEINBERGEROVÁ (203 Česká republika, domácí), A. WARRIS, DEA. LOCKHART, B. JONES, C. CORDONNIER, J. P. DONELLY a R. A. BARNES

Vydání

Journal of Antimicrobial Chemotherapy, Oxford, Oxford University Press, 2021, 0305-7453

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30303 Infectious Diseases

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 5.758

Kód RIV

RIV/00216224:14110/21:00121104

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.1093/jac/dkaa498

UT WoS

000620821900013

Klíčová slova anglicky

Aspergillus PCR blood testing; invasive aspergillosis; anti-mould prophylaxis

Štítky

14110212, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 7. 4. 2021 10:44, Mgr. Tereza Miškechová

Anotace

V originále

Background: The performance of the galactomannan enzyme immunoassay (GM-EIA) is impaired in patients receiving mould-active antifungal therapy. The impact of mould-active antifungal therapy on Aspergillus PCR testing needs to be determined. Objectives: To determine the influence of anti-mould prophylaxis (AMP) on the performance of PCR blood testing to aid the diagnosis of proven/probable invasive aspergillosis (IA). Methods: As part of the systematic review and meta-analysis of 22 cohort studies investigating Aspergillus PCR blood testing in 2912 patients at risk of IA, subgroup analysis was performed to determine the impact of AMP on the accuracy of Aspergillus PCR. The incidence of IA was calculated in patients receiving and not receiving AMP. The impact of two different positivity thresholds (requiring either a single PCR positive test result or >= 2 consecutive PCR positive test results) on accuracy was evaluated. Meta-analytical pooling of sensitivity and specificity was performed by Logistic mixed-model regression. Results: In total, 1661 (57%) patients received prophylaxis. The incidence of IA was 14.2%, significantly Lower in the prophylaxis group (11%-12%) compared with the non-prophylaxis group (18%-19%) (P< 0.001). The use of AMP did not affect sensitivity, but significantly decreased specificity [single PCR positive result threshold: 26% reduction (P= 0.005); >= 2 consecutive PCR positive results threshold: 12% reduction (P= 0.019)]. Conclusions: Contrary to its influence on GM-EIA, AMP significantly decreases Aspergillus PCR specificity, without affecting sensitivity, possibly as a consequence of AMP Limiting the clinical progression of IA and/or Leading to false-negative GM-EIA results, preventing the classification of probable IA using the EORTC/MSGERC definitions.

Citovat

CRUCIANI, M., P. L. WHITE, C. MENGOLI, J. LÖFFLER, C. O. MORTON, L. KLINGSPOR, D. BUCHHEIDT, J. MAERTENS, W. J. HEINZ, T. R. ROGERS, Barbora WEINBERGEROVÁ, A. WARRIS, DEA. LOCKHART, B. JONES, C. CORDONNIER, J. P. DONELLY a R. A. BARNES. The impact of anti-mould prophylaxis on Aspergillus PCR blood testing for the diagnosis of invasive aspergillosis. Journal of Antimicrobial Chemotherapy. Oxford: Oxford University Press, 2021, roč. 76, č. 3, s. 635-638. ISSN 0305-7453. Dostupné z: https://dx.doi.org/10.1093/jac/dkaa498.

@article{1738798,
   author = {Cruciani, M. and White, P. L. and Mengoli, C. and Löffler, J. and Morton, C. O. and Klingspor, L. and Buchheidt, D. and Maertens, J. and Heinz, W. J. and Rogers, T. R. and Weinbergerová, Barbora and Warris, A. and Lockhart, DEA. and Jones, B. and Cordonnier, C. and Donelly, J. P. and Barnes, R. A.},
   article_location = {Oxford},
   article_number = {3},
   doi = {http://dx.doi.org/10.1093/jac/dkaa498},
   keywords = {Aspergillus PCR blood testing; invasive aspergillosis; anti-mould prophylaxis},
   language = {eng},
   issn = {0305-7453},
   journal = {Journal of Antimicrobial Chemotherapy},
   title = {The impact of anti-mould prophylaxis on Aspergillus PCR blood testing for the diagnosis of invasive aspergillosis.},
   url = {https://academic.oup.com/jac/article-abstract/76/3/635/6055077?redirectedFrom=fulltext},
   volume = {76},
   year = {2021}
}

TY  - JOUR
ID  - 1738798
AU  - Cruciani, M. - White, P. L. - Mengoli, C. - Löffler, J. - Morton, C. O. - Klingspor, L. - Buchheidt, D. - Maertens, J. - Heinz, W. J. - Rogers, T. R. - Weinbergerová, Barbora - Warris, A. - Lockhart, DEA. - Jones, B. - Cordonnier, C. - Donelly, J. P. - Barnes, R. A.
PY  - 2021
TI  - The impact of anti-mould prophylaxis on Aspergillus PCR blood testing for the diagnosis of invasive aspergillosis.
JF  - Journal of Antimicrobial Chemotherapy
VL  - 76
IS  - 3
SP  - 635-638
EP  - 635-638
PB  - Oxford University Press
SN  - 03057453
KW  - Aspergillus PCR blood testing
KW  - invasive aspergillosis
KW  - anti-mould prophylaxis
UR  - https://academic.oup.com/jac/article-abstract/76/3/635/6055077?redirectedFrom=fulltext
N2  - Background: The performance of the galactomannan enzyme immunoassay (GM-EIA) is impaired in patients receiving mould-active antifungal therapy. The impact of mould-active antifungal therapy on Aspergillus PCR testing needs to be determined. Objectives: To determine the influence of anti-mould prophylaxis (AMP) on the performance of PCR blood testing to aid the diagnosis of proven/probable invasive aspergillosis (IA). Methods: As part of the systematic review and meta-analysis of 22 cohort studies investigating Aspergillus PCR blood testing in 2912 patients at risk of IA, subgroup analysis was performed to determine the impact of AMP on the accuracy of Aspergillus PCR. The incidence of IA was calculated in patients receiving and not receiving AMP. The impact of two different positivity thresholds (requiring either a single PCR positive test result or >= 2 consecutive PCR positive test results) on accuracy was evaluated. Meta-analytical pooling of sensitivity and specificity was performed by Logistic mixed-model regression. Results: In total, 1661 (57%) patients received prophylaxis. The incidence of IA was 14.2%, significantly Lower in the prophylaxis group (11%-12%) compared with the non-prophylaxis group (18%-19%) (P< 0.001). The use of AMP did not affect sensitivity, but significantly decreased specificity [single PCR positive result threshold: 26% reduction (P= 0.005); >= 2 consecutive PCR positive results threshold: 12% reduction (P= 0.019)]. Conclusions: Contrary to its influence on GM-EIA, AMP significantly decreases Aspergillus PCR specificity, without affecting sensitivity, possibly as a consequence of AMP Limiting the clinical progression of IA and/or Leading to false-negative GM-EIA results, preventing the classification of probable IA using the EORTC/MSGERC definitions.
ER  -

CRUCIANI, M., P. L. WHITE, C. MENGOLI, J. LÖFFLER, C. O. MORTON, L. KLINGSPOR, D. BUCHHEIDT, J. MAERTENS, W. J. HEINZ, T. R. ROGERS, Barbora WEINBERGEROVÁ, A. WARRIS, DEA. LOCKHART, B. JONES, C. CORDONNIER, J. P. DONELLY a R. A. BARNES. The impact of anti-mould prophylaxis on Aspergillus PCR blood testing for the diagnosis of invasive aspergillosis. \textit{Journal of Antimicrobial Chemotherapy}. Oxford: Oxford University Press, 2021, roč.~76, č.~3, s.~635-638. ISSN~0305-7453. Dostupné z: https://dx.doi.org/10.1093/jac/dkaa498.

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