PCR-ELISA FOR THE EARLY DIAGNOSIS OF INVASIVE PULMONARY ASPERGILLUS INFECTION IN NEUTROPENIC PATIENTS

Aim-To evaluate a newly developed aspergillus mitochondrial gene PCR-E LISA assay for the early diagnosis of invasive pulmonary aspergillosis (IPA) in neutropenic patients. Methods-The aspergillus mitochondrial gene was chosen for the amplification target for use with a solution h ybridisation assay with colorimetric end stage detection in microtitre plate format (PCR-ELISA). The study group comprised neutropenic patie nts undergoing febrile episodes not responding to standard antibacteri al antibiotics. Patients underwent computed tomography and bronchoscop y. Bronchoalveolar lavage (BAL) fluids were examined by culture and PC R. Results-The aspergillus mitochondrial gene PCR-ELISA was both sensi tive (100%) and specific (100%) for IPA in neutropenic patients. All 1 2 patients with definite or probable IPA had PCR positive BAL fluids. None of the patients with undiagnosed or confirmed infections of other aetiologies were mitochondrial PCR positive. Speciation based upon am plicon size difference was possible. Conclusions-Aspergillus mitochond rial DNA PCR-ELISA on BAL fluid is useful in the early diagnosis of IP A in neutropenic patients alone or, potentially, as an indication for thoracic computed tomography.