Diagnosis of invasive aspergillosis in hematological malignancy patients: Performance of cytokines, Asp LFD, and Aspergillus PCR in same day blood and bronchoalveolar lavage samples.
Diagnosis of invasive aspergillosis in hematological malignancy patients: Performance of cytokines, Asp LFD, and Aspergillus PCR in same day blood and bronchoalveolar lavage samples.
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DOI：
10.1016/j.jinf.2018.05.001
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发表时间：
2018-09
期刊：
影响因子：
--
通讯作者：
Hoenigl M
中科院分区：
文献类型：
--
作者：
Heldt S;Prattes J;Eigl S;Spiess B;Flick H;Rabensteiner J;Johnson G;Prüller F;Wölfler A;Niedrist T;Boch T;Neumeister P;Strohmaier H;Krause R;Buchheidt D;Hoenigl M
曲霉属诱导几种细胞因子水平升高。目前尚不清楚这些细胞因子是否具有临床常规价值，并增强侵袭性曲霉病（IA）的已建立和新型生物标志物/检测的诊断性能。该队列研究纳入了106例前瞻性入组（2014-2017年）接受支气管镜检查的基础血液学恶性肿瘤和疑似肺部感染成人病例。在支气管肺泡灌洗液（BALF）采样后24小时内采集血清样本。血清和支气管肺泡灌洗液样本均用于评估曲霉特异性侧流装置测试（LFD）、曲霉PCR、β-D-葡聚糖和细胞因子的诊断性能，这些测试之前已显示出与IA的显着相关性。在106例病例中，11例可能为IA，32例可能为IA; 80%在采样时接受了霉菌活性抗真菌药物。诊断试验和生物标志物显示BALF中的性能优于血液，但血清白细胞介素（IL）-8除外，后者是最可靠的血液生物标志物。血清IL-8与BALF LFD（灵敏度100%，特异性94%）或BALF PCR（灵敏度91%，特异性97%）的组合显示出区分可能的IA与无IA的希望。高血清IL-8水平是高度特异性的，并且当与BALF曲霉特异性LFD或BALF曲霉PCR结合时，对于IA的诊断也是高度敏感的。
Aspergillus spp. induce elevated levels of several cytokines. It remains unknown whether these cytokines hold value for clinical routine and enhance diagnostic performances of established and novel biomarkers/tests for invasive aspergillosis (IA). This cohort study included 106 prospectively enrolled (2014–2017) adult cases with underlying hematological malignancies and suspected pulmonary infection undergoing bronchoscopy. Serum samples were collected within 24 hours of bronchoalveolar lavage fluid (BALF) sampling. Both, serum and BALF samples were used to evaluate diagnostic performances of the Aspergillus-specific lateral-flow device test (LFD), Aspergillus PCR, β-D-glucan, and cytokines that have shown significant associations with IA before . Among 106 cases, 11 had probable IA, and 32 possible IA; 80% received mold-active antifungals at the time of sampling. Diagnostic tests and biomarkers showed better performance in BALF versus blood, with the exception of serum interleukin (IL)-8 which was the most reliable blood biomarker. Combinations of serum IL-8 with either BALF LFD (sensitivity 100%, specificity 94%) or BALF PCR (sensitivity 91%, specificity 97%) showed promise for differentiating probable IA from no IA. High serum IL-8 levels were highly specific, and when combined with either the BALF Aspergillus-specific LFD, or BALF Aspergillus PCR also highly sensitive for diagnosis of IA.
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影响因子：
11.8
作者：
Duarte, Rafael F.;Sanchez-Ortega, Isabel;Cuenca-Estrella, Manuel
通讯作者：
Cuenca-Estrella, Manuel
影响因子：
3.7
作者：
Potenza L;Vallerini D;Barozzi P;Riva G;Forghieri F;Beauvais A;Beau R;Candoni A;Maertens J;Rossi G;Morselli M;Zanetti E;Quadrelli C;Codeluppi M;Guaraldi G;Pagano L;Caira M;Del Giovane C;Maccaferri M;Stefani A;Morandi U;Tazzioli G;Girardis M;Delia M;Specchia G;Longo G;Marasca R;Narni F;Merli F;Imovilli A;Apolone G;Carvalho A;Comoli P;Romani L;Latgè JP;Luppi M
通讯作者：
Luppi M
影响因子：
9.4
作者：
Mery A;Sendid B;François N;Cornu M;Poissy J;Guerardel Y;Poulain D
通讯作者：
Poulain D
影响因子：
6.4
作者：
Bidula, Stefan;Sexton, Darren W.;Schelenz, Silke
通讯作者：
Schelenz, Silke
影响因子：
9.4
作者：
Hoenigl, M.;Prattes, J.;Buchheidt, D.
通讯作者：
Buchheidt, D.