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Is the COVID-19 Pandemic a Good Time to Include Aspergillus Molecular Detection to Categorize Aspergillosis in ICU Patients? A Monocentric Experience
(1) Background: The diagnosis of invasive aspergillosis (IA) in an intensive care unit (ICU) remains a challenge and the COVID-19 epidemic makes it even harder. Here, we evaluated Aspergillus PCR input to help classifying IA in SARS-CoV-2-infected patients. (2) Methods: 45 COVID-19 patients were pro...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7558333/ https://www.ncbi.nlm.nih.gov/pubmed/32664423 http://dx.doi.org/10.3390/jof6030105 |
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author | Gangneux, Jean-Pierre Reizine, Florian Guegan, Hélène Pinceaux, Kieran Le Balch, Pierre Prat, Emilie Pelletier, Romain Belaz, Sorya Le Souhaitier, Mathieu Le Tulzo, Yves Seguin, Philippe Lederlin, Mathieu Tadié, Jean-Marc Robert-Gangneux, Florence |
author_facet | Gangneux, Jean-Pierre Reizine, Florian Guegan, Hélène Pinceaux, Kieran Le Balch, Pierre Prat, Emilie Pelletier, Romain Belaz, Sorya Le Souhaitier, Mathieu Le Tulzo, Yves Seguin, Philippe Lederlin, Mathieu Tadié, Jean-Marc Robert-Gangneux, Florence |
author_sort | Gangneux, Jean-Pierre |
collection | PubMed |
description | (1) Background: The diagnosis of invasive aspergillosis (IA) in an intensive care unit (ICU) remains a challenge and the COVID-19 epidemic makes it even harder. Here, we evaluated Aspergillus PCR input to help classifying IA in SARS-CoV-2-infected patients. (2) Methods: 45 COVID-19 patients were prospectively monitored twice weekly for Aspergillus markers and anti-Aspergillus serology. We evaluated the concordance between (I) Aspergillus PCR and culture in respiratory samples, and (II) blood PCR and serum galactomannan. Patients were classified as putative/proven/colonized using AspICU algorithm and two other methods. (3) Results: The concordance of techniques applied on respiratory and blood samples was moderate (kappa = 0.58 and kappa = 0.63, respectively), with a higher sensitivity of PCR. According to AspICU, 9/45 patients were classified as putative IA. When incorporating PCR results, 15 were putative IA because they met all criteria, probably with a lack of specificity in the context of COVID-19. Using a modified AspICU algorithm, eight patients were classified as colonized and seven as putative IA. (4) Conclusion: An appreciation of the fungal burden using PCR and Aspergillus serology was added to propose a modified AspICU algorithm. This proof of concept seemed relevant, as it was in agreement with the outcome of patients, but will need validation in larger cohorts. |
format | Online Article Text |
id | pubmed-7558333 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-75583332020-10-22 Is the COVID-19 Pandemic a Good Time to Include Aspergillus Molecular Detection to Categorize Aspergillosis in ICU Patients? A Monocentric Experience Gangneux, Jean-Pierre Reizine, Florian Guegan, Hélène Pinceaux, Kieran Le Balch, Pierre Prat, Emilie Pelletier, Romain Belaz, Sorya Le Souhaitier, Mathieu Le Tulzo, Yves Seguin, Philippe Lederlin, Mathieu Tadié, Jean-Marc Robert-Gangneux, Florence J Fungi (Basel) Article (1) Background: The diagnosis of invasive aspergillosis (IA) in an intensive care unit (ICU) remains a challenge and the COVID-19 epidemic makes it even harder. Here, we evaluated Aspergillus PCR input to help classifying IA in SARS-CoV-2-infected patients. (2) Methods: 45 COVID-19 patients were prospectively monitored twice weekly for Aspergillus markers and anti-Aspergillus serology. We evaluated the concordance between (I) Aspergillus PCR and culture in respiratory samples, and (II) blood PCR and serum galactomannan. Patients were classified as putative/proven/colonized using AspICU algorithm and two other methods. (3) Results: The concordance of techniques applied on respiratory and blood samples was moderate (kappa = 0.58 and kappa = 0.63, respectively), with a higher sensitivity of PCR. According to AspICU, 9/45 patients were classified as putative IA. When incorporating PCR results, 15 were putative IA because they met all criteria, probably with a lack of specificity in the context of COVID-19. Using a modified AspICU algorithm, eight patients were classified as colonized and seven as putative IA. (4) Conclusion: An appreciation of the fungal burden using PCR and Aspergillus serology was added to propose a modified AspICU algorithm. This proof of concept seemed relevant, as it was in agreement with the outcome of patients, but will need validation in larger cohorts. MDPI 2020-07-10 /pmc/articles/PMC7558333/ /pubmed/32664423 http://dx.doi.org/10.3390/jof6030105 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Gangneux, Jean-Pierre Reizine, Florian Guegan, Hélène Pinceaux, Kieran Le Balch, Pierre Prat, Emilie Pelletier, Romain Belaz, Sorya Le Souhaitier, Mathieu Le Tulzo, Yves Seguin, Philippe Lederlin, Mathieu Tadié, Jean-Marc Robert-Gangneux, Florence Is the COVID-19 Pandemic a Good Time to Include Aspergillus Molecular Detection to Categorize Aspergillosis in ICU Patients? A Monocentric Experience |
title | Is the COVID-19 Pandemic a Good Time to Include Aspergillus Molecular Detection to Categorize Aspergillosis in ICU Patients? A Monocentric Experience |
title_full | Is the COVID-19 Pandemic a Good Time to Include Aspergillus Molecular Detection to Categorize Aspergillosis in ICU Patients? A Monocentric Experience |
title_fullStr | Is the COVID-19 Pandemic a Good Time to Include Aspergillus Molecular Detection to Categorize Aspergillosis in ICU Patients? A Monocentric Experience |
title_full_unstemmed | Is the COVID-19 Pandemic a Good Time to Include Aspergillus Molecular Detection to Categorize Aspergillosis in ICU Patients? A Monocentric Experience |
title_short | Is the COVID-19 Pandemic a Good Time to Include Aspergillus Molecular Detection to Categorize Aspergillosis in ICU Patients? A Monocentric Experience |
title_sort | is the covid-19 pandemic a good time to include aspergillus molecular detection to categorize aspergillosis in icu patients? a monocentric experience |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7558333/ https://www.ncbi.nlm.nih.gov/pubmed/32664423 http://dx.doi.org/10.3390/jof6030105 |
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