Abstract:
:COVID-19-associated pulmonary aspergillosis (CAPA) was recently reported as a potential infective complication affecting critically ill patients with acute respiratory distress syndrome following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, with incidence rates varying from 8 to 33% depending on the study. However, definitive diagnosis of CAPA is challenging. Standardized diagnostic algorithms and definitions are lacking, clinicians are reticent to perform aerosol-generating bronchoalveolar lavages for galactomannan testing and microscopic and cultural examination, and questions surround the diagnostic sensitivity of different serum biomarkers. Between 11 March and 14 July 2020, the UK National Mycology Reference Laboratory received 1,267 serum and respiratory samples from 719 critically ill UK patients with COVID-19 and suspected pulmonary aspergillosis. The laboratory also received 46 isolates of Aspergillus fumigatus from COVID-19 patients (including three that exhibited environmental triazole resistance). Diagnostic tests performed included 1,000 (1-3)-β-d-glucan and 516 galactomannan tests on serum samples. The results of this extensive testing are presented here. For a subset of 61 patients, respiratory specimens (bronchoalveolar lavage specimens, tracheal aspirates, and sputum samples) in addition to serum samples were submitted and subjected to galactomannan testing, Aspergillus-specific PCR, and microscopy and culture. The incidence of probable/proven and possible CAPA in this subset of patients was approximately 5% and 15%, respectively. Overall, our results highlight the challenges in biomarker-driven diagnosis of CAPA, especially when only limited clinical samples are available for testing, and the importance of a multimodal diagnostic approach involving regular and repeat testing of both serum and respiratory samples.
journal_name
J Clin Microbioljournal_title
Journal of clinical microbiologyauthors
Borman AM,Palmer MD,Fraser M,Patterson Z,Mann C,Oliver D,Linton CJ,Gough M,Brown P,Dzietczyk A,Hedley M,McLachlan S,King J,Johnson EMdoi
10.1128/JCM.02136-20subject
Has Abstractpub_date
2020-12-17 00:00:00issue
1eissn
0095-1137issn
1098-660Xpii
JCM.02136-20journal_volume
59pub_type
杂志文章abstract::We compared putative molecular markers of virulence (vacA, cagA, and iceA) of Helicobacter pylori strains isolated from 52 adult duodenal ulcer patients from West Bengal, India, with those of H. pylori strains isolated from 48 adult healthy volunteers from the same region. On the basis of genotyping by PCR, we conclud...
journal_title:Journal of clinical microbiology
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doi:10.1128/jcm.40.7.2622-2625.2002
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journal_title:Journal of clinical microbiology
pub_type: 杂志文章
doi:10.1128/JCM.36.6.1683-1687.1998
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journal_title:Journal of clinical microbiology
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journal_title:Journal of clinical microbiology
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journal_title:Journal of clinical microbiology
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doi:10.1128/jcm.41.12.5735-5737.2003
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journal_title:Journal of clinical microbiology
pub_type: 杂志文章
doi:10.1128/JCM.34.7.1819-1820.1996
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journal_title:Journal of clinical microbiology
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doi:10.1128/JCM.26.10.2044-2047.1988
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journal_title:Journal of clinical microbiology
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doi:10.1128/JCM.37.1.95-98.1999
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journal_title:Journal of clinical microbiology
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journal_title:Journal of clinical microbiology
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journal_title:Journal of clinical microbiology
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doi:10.1128/JCM.27.2.359-360.1989
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journal_title:Journal of clinical microbiology
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doi:10.1128/JCM.33.10.2792-2795.1995
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journal_title:Journal of clinical microbiology
pub_type: 杂志文章
doi:10.1128/JCM.28.10.2335-2339.1990
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journal_title:Journal of clinical microbiology
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更新日期:1993-07-01 00:00:00
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journal_title:Journal of clinical microbiology
pub_type: 杂志文章
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journal_title:Journal of clinical microbiology
pub_type: 杂志文章
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更新日期:1979-12-01 00:00:00