Diagnosing and monitoring of invasive aspergillosis during antifungal therapy by polymerase chain reaction: an experimental study in mice

Diagn Microbiol Infect Dis. 2003 Dec;47(4):569-72. doi: 10.1016/s0732-8893(03)00168-8.

Abstract

This study evaluated the value of polymerase chain reaction (PCR) for diagnosing and monitoring of invasive aspergillosis during amphotericin B therapy. PCR, microscopy and culture of tissues samples (n = 126) and blood samples (n = 78) of experimentally infected mice (n = 42) were performed. The PCR results of treated were compared to those of untreated animals; Aspergillus fumigatus and A. terreus were used in this study. In the amphotericin B treated group the sensitivities of PCR, microscopic examination and culture of the various tissues were 69, 58, and 53%, respectively; the specificities of all examinations were 100%. In the untreated group the sensitivities of PCR, microscopic examination, and culture were 72, 64, and 57%, respectively; the specificities of all examinations were 100%. The 78 blood samples taken from mice under therapy were tested by PCR over a period of 8 days following Aspergillus infection. The test sensitivity was 77%, the specificity 46%, the positive predictive value 59%, and the negative predictive value 67%. In the untreated group the sensitivity was 92%, the specificity 46%, the positive predictive value 63%, and the negative predictive value 86%. The results suggest that this PCR method has possible clinical value for improving the diagnosis of invasive Aspergillus infection. Monitoring of blood under antifungal therapy is not recommended.

Publication types

  • Comparative Study

MeSH terms

  • Amphotericin B / pharmacology*
  • Animals
  • Antifungal Agents / pharmacology
  • Aspergillosis / diagnosis*
  • Aspergillosis / drug therapy*
  • DNA, Fungal / analysis
  • Disease Models, Animal
  • Female
  • Fungemia / diagnosis*
  • Fungemia / drug therapy*
  • Mice
  • Mice, Inbred BALB C
  • Polymerase Chain Reaction / methods*
  • Reference Values
  • Sensitivity and Specificity

Substances

  • Antifungal Agents
  • DNA, Fungal
  • Amphotericin B