Impact of Aspergillus PCR on the management of invasive aspergillosis: A tertiary care hospital experience during the COVID-19 pandemic

Muhammed Cihan Işık; Gökhan Metan; Alpaslan Alp; Dolunay Gülmez; Sevtap Arikan-Akdagli; Ömrüm Uzun

doi:10.1016/j.diagmicrobio.2024.116658

Impact of Aspergillus PCR on the management of invasive aspergillosis: A tertiary care hospital experience during the COVID-19 pandemic

Diagn Microbiol Infect Dis. 2024 Dec 15;111(3):116658. doi: 10.1016/j.diagmicrobio.2024.116658. Online ahead of print.

Authors

Muhammed Cihan Işık¹, Gökhan Metan², Alpaslan Alp³, Dolunay Gülmez⁴, Sevtap Arikan-Akdagli⁵, Ömrüm Uzun⁶

Affiliations

¹ Department of Infectious Diseases and Clinical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Türkiye. Electronic address: m.cihan.i.94@gmail.com.
² Department of Infectious Diseases and Clinical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Türkiye. Electronic address: gokhanmetan@gmail.com.
³ Department of Medical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Türkiye. Electronic address: alp1086@gmail.com.
⁴ Department of Medical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Türkiye. Electronic address: dolunayglm@gmail.com.
⁵ Department of Medical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Türkiye. Electronic address: sarikanakdagli@gmail.com.
⁶ Department of Infectious Diseases and Clinical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Türkiye. Electronic address: omrumuzun@gmail.com.

PMID: 39733634
DOI: 10.1016/j.diagmicrobio.2024.116658

Abstract

Aim: To assess the impact of Aspergillus PCR on managing invasive aspergillosis (IA) in routine patient management.

Methods: A retrospective study included 235 patients who had Aspergillus PCR tests performed on respiratory samples (bronchoalveolar lavage, non-bronchoscopic lavage, and sputum) from November 2020 to April 2022.

Results: Of 293 tests, 11.9% were PCR positive. Positive PCR results did not alter IA diagnostic categories. The decision on antifungal treatment was based on PCR results in nine of the 54 treated patients. Ten patients with positive PCR were not treated due to clinical improvement while awaiting results.

Conclusion: The utility of Aspergillus PCR was constrained by the use of non-validated samples and delays in reporting, reducing its impact on management decisions during a time when bronchoscopy was limited due to COVID-19. To enhance its clinical effectiveness and cost-efficiency, implementing a diagnostic algorithm for appropriate use is essential.

Keywords: Aspergillus PCR; CAPA; COVID-19; Invasive aspergillosis.