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Quantitative Real-Time PCR and Platelia Galactomannan Assay for the Diagnosis of Invasive Pulmonary Aspergillosis: Bronchoalveolar Lavage Fluid Performs Better Than Serum in Non-neutropaenic Patients

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Abstract

The diagnosis of invasive pulmonary aspergillosis (IPA) is still in challenge in clinical practice, particularly for those patients without an obvious neutropaenia. In this study, a well-validated qPCR method and Platelia galactomannan (GM) assay were compared for their diagnostic performance using paired samples of bronchoalveolar lavage (BAL) fluid and serum from predominantly non-neutropaenic patients. In the serum samples, qPCR showed a comparable performance with GM assay in terms of sensitivity and specificity. In the BAL samples, qPCR and GM assay both demonstrated a good sensitivity (90 vs. 90 %); however, the specificity of qPCR was higher than that of GM assay (92.5 vs. 68.8 %, P < 0.001) in these samples. A better sensitivity was obtained with BAL compared with serum samples for both GM assay (90 vs. 50 %) and qPCR (90 vs. 60 %). In conclusion, in non-neutropaenic patients, BAL appears to provide improved sensitivity for both GM and qPCR assays. BAL qPCR offers a better diagnostic value for IPA compared with BAL GM assay, significantly increasing the specificity without affecting the sensitivity.

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Acknowledgments

This work was supported by National Science and Technology Major Project (2013ZX10004612-002).

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Authors and Affiliations

  1. Research Center for Medical Mycology, Department of Dermatology and Venereology, Peking University First Hospital, Peking University, Beijing, 100034, China

    Shuzhen Zhang, Sibu Wang, Zhe Wan, Ruoyu Li & Jin Yu

  2. Beijing Key Laboratory of Molecular Diagnosis of Dermatoses, Beijing, China

    Shuzhen Zhang, Sibu Wang, Zhe Wan, Ruoyu Li & Jin Yu

  3. Department of Respiratory, Peking University First Hospital, Beijing, China

    Chengli Que

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  1. Shuzhen Zhang
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  2. Sibu Wang
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  6. Jin Yu
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Correspondence to Jin Yu.

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Zhang, S., Wang, S., Wan, Z. et al. Quantitative Real-Time PCR and Platelia Galactomannan Assay for the Diagnosis of Invasive Pulmonary Aspergillosis: Bronchoalveolar Lavage Fluid Performs Better Than Serum in Non-neutropaenic Patients. Mycopathologia 181, 625–629 (2016). https://doi.org/10.1007/s11046-016-0024-5

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  • DOI: https://doi.org/10.1007/s11046-016-0024-5

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