Steinmann J, Buer J, Rath P-M, Paul A, Saner F
Institute of Medical Microbiology, University Hospital Essen, Essen, Germany.
Transpl Infect Dis. 2009 Apr;11(2):175-8. doi: 10.1111/j.1399-3062.2009.00367.x. Epub 2009 Feb 5.
We report the clinical features, diagnosis, and monitoring findings of invasive aspergillosis (IA) in 2 liver transplant recipients. Blood/serum samples and bronchoalveolar lavage (BAL) fluids were analyzed by a novel commercial polymerase chain reaction (PCR) assay (SeptiFast) and an Aspergillus galactomannan (GM) enzyme-linked immunoassay (EIA). The diagnosis of IA could be performed in <6 h with the detection of Aspergillus fumigatus DNA in blood and BAL fluid. High GM values (mean: 9.1, range: 7.3-10.8) in serum and BAL fluid confirmed the SeptiFast result. Follow-up of the SeptiFast findings and GM index correlated with the clinical course. The molecular detection of A. fumigatus-specific DNA and GM test in blood/serum and BAL samples appears to be a useful tool for prompt diagnosis of IA. Further prospective clinical trials are necessary to evaluate the accuracy of SeptiFast and the GM test in diagnosing IA.
我们报告了2例肝移植受者侵袭性曲霉病（IA）的临床特征、诊断及监测结果。采用一种新型商业聚合酶链反应（PCR）检测法（SeptiFast）和曲霉半乳甘露聚糖（GM）酶联免疫吸附测定（EIA）对血液/血清样本及支气管肺泡灌洗（BAL）液进行分析。通过检测血液和BAL液中的烟曲霉DNA，可在6小时内完成IA的诊断。血清和BAL液中GM值较高（平均值：9.1，范围：7.3 - 10.8）证实了SeptiFast检测结果。SeptiFast检测结果及GM指数的随访与临床病程相关。血液/血清及BAL样本中烟曲霉特异性DNA的分子检测和GM检测似乎是快速诊断IA的有用工具。有必要进行进一步的前瞻性临床试验以评估SeptiFast和GM检测在诊断IA方面的准确性。
