Invasive Aspergillosis
Conditions
Keywords
invasive aspergillosis, PCR
Brief summary
Invasive aspergillosis (IA) is the most common mould infection in immunocompromised patients with haematological disease. Voriconazole, a triazole, improves overall survival of patients with an IA and is the mainstay of therapy. Resistance of A. Fumigatus emerged as an important clinical problem and infections with azole resistant Aspergillus have a high mortality. Nowhere in the world, azole resistance is more prevalent than in the Netherlands. Rapid detection of resistance is key to improve the patient's outcome but fungal cultures take time and are often negative. The investigators aim to detect azole resistance associated mutations in fungal DNA extracted directly from serum or plasma to accelerate diagnosis and improve outcome of patients infected with azole resistant A. fumigatus.
Interventions
DIAGNOSTIC_TESTAspergillus PCR
Aspergillus PCR will be performed on different volumes of serum and plasma of patients with hematological malignancies with suspicion for invasive fungal infection.
Sponsors
Bart Rijnders
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Inclusion criteria
* 18 years or older. * Lung CT shows lesions that fulfil the EORTC/MSG radiological criteria of possible invasive fungal infection. * A bronchoalveolar lavage is planned or has been performed \<48hrs earlier
Exclusion criteria
\- Patients unable or unwilling to provide consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Performance of two different PCR test | 1 week | The sensitivity and specificity will be determined of the different PCR's tested including the commercially available AsperGenius (Pathonostics, Maastricht) and the in-house PCR. For this purpose a patients diagnosed with proven or probable IPA according to the EORTC/MSG definition will be used as the gold standard. |
| Performance of two different media for the PCR test | 1 week | Extraction medium (serum versus plasma) and extraction volume (1, 3 or 10 ml) that results in best sensitivity and specificity will be determined |
| Determination of best PCR cycle threshold | 1 week | Extraction medium (serum versus plasma) and extraction volume (1, 3 or 10 ml) that results in best sensitivity and specificity will be determined |
Countries
Netherlands
Contacts
Primary ContactBart Rijnders, MD, PhD
Backup ContactHanne Lamberink, MD
Outcome results
None listed