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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
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.
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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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