Polymerase Chain Reaction in Serum for Diagnosis of Aspergillosis

Introduction: Aspergillosis is a major threat for immunocompromised and critically ill patients. Early diagnosis and initiation of appropriate antifungal therapy are essential for favorable clinical outcome. Aim: The aim of this study was to evaluate the performance of a PCR assay in serum, compared to conventional method, for the diagnosis of aspergillosis. Material and methods: Specimens of 125 patients divided into 4 groups, classified according to clinical diagnosis and EORTC/MSG criteria, were analysed at the Institute of Microbiology and Parasitology, Faculty of Medicine, Skopje, with conventional and molecular methods, during a period of two years (2014-2016). Results: Seventy-one isolates of Aspergillus were confirmed in BAL culture. Aspergillus was detected in 63.33% of patients with chronic aspergillosis, followed by 56.67% of cystic fibrosis patients, 51.43% of patients with primary immunodeficiency, and 43.33% of patients with prolonged stay in ICU. Sensitivity and specificity of BAL culture were: 64.29% and 100%, 59.09% and 100%, 54.55% and 12.5%, 100% and 54.17%, in the I, II, III and IV group, respectively. PCR performed in serum yielded the following results for sensitivity and specificity: 53.57% and 100% in group I, 36.36% and 100% in group II, 9.09% and 100% in group III, respectively. Serum PCR was not performed in the group with cystic fibrosis. Conclusion: Our results indicate that PCR in serum could be a useful adjunct test for diagnosis of aspergillosis, along with results from conventional mycological method, so a timely antifungal treatment with a favorable clinical outcome, is achieved.