Evaluation of Three Commercial PCR Assays for the Detection of Azole-Resistant <i>Aspergillus fumigatus</i> from Respiratory Samples of Immunocompromised Patients

oleh: Ulrike Scharmann, Lisa Kirchhoff, Andrea Hain, Jan Buer, Michael Koldehoff, Joerg Steinmann, Peter-Michael Rath

Format: Article
Diterbitkan: MDPI AG 2021-02-01

Deskripsi

This is the first study comparing three commercially available PCR assays for the detection of <i>Aspergillus</i> DNA from respiratory specimen of immunocompromised patients and the presence of <i>cyp51A</i> gene mutations. Bronchoalveolar lavages (BALs, <i>N</i> = 103) from patients with haematological/oncological underlying diseases were retrospectively investigated. The performance of three PCR assays, namely MycoGENIE<sup>®</sup><i>Aspergillus fumigatus</i> Real-Time PCR Kit (Adamtech), Fungiplex<sup>®</sup><i>Aspergillus</i> Azole-R IVD Real-Time PCR Kit (Bruker Daltonik GmbH) and AsperGenius<sup>®</sup> (PathoNostics B.V.), were evaluated. All patients were categorised following current EORTC/MSG criteria, with exclusion of the PCR-results. From the 11 invasive pulmonary aspergillosis (IPA) probable samples, eight were detected with MycoGENIE<sup>®</sup>, resulting in a sensitivity of 80% and a specificity of 73%. Furthermore, Fungiplex<sup>®</sup> resulted in six positive BALs with a sensitivity of 60% and a specificity of 91% and AsperGenius<sup>®</sup> in seven positive BAL samples, with a sensitivity of 64% and a specificity of 97%. No proven IPA was detected. One isolate showed phenotypically an azole-resistance, which was also detected in each of the tested PCR assays with the mutation in TR34. The here tested PCR assays were capable of reliably detecting <i>A. fumigatus</i> DNA, as well as differentiation of the common <i>cyp51A</i> gene mutations. However, evaluation on the AsperGenius<sup>®</sup> assay revealed a low risk of false positive results.