Prospective multicentre PCR-based Aspergillus DNA screening in high-risk XXXX with and without primary antifungal mould prophylaxis.

@entity1 @entity5 @entity2286 @entity281 @entity1778 @entity364 @entity3
UNASSIGNED: @entity3 ( @entity3 ) is associated with significant morbidity and mortality, and, among other factors, this is due to a delay in diagnosis performed with conventional techniques. A prospective, multicentre study was conducted to evaluate the efficacy of Aspergillus DNA screening in the early diagnosis of @entity3 . @entity1 undergoing haematopoietic stem cell transplantation or chemotherapy for acute @entity1778 were enrolled for biomarker screening. Three centres applied the same protocol for in-house PCR, which was compliant with the European Aspergillus PCR Initiative recommendations, to guarantee the highest diagnostic standards. Two thousand one hundred and twenty-eight sera from 213 @entity1 were investigated and stratified according to the revised European Organization for the Research and Treatment of @entity5 /Mycoses Study Group criteria for invasive @entity364 . The incidence rates of probable and possible @entity3 were 18% and 38%, respectively. The sensitivity, specificity and positive predictive value ( @entity2286 ) of PCR were superior in antifungal drug-naive @entity1 , being 71.4%, 92.3%, and 62.5%, respectively. The last of these key performance indicators ( @entity2286 ) was moderate in @entity1 receiving primary prophylaxis, at 5.4%. Negative predictive values for both strategies applied were 100% with and 98.3% without antifungal mould prophylaxis. PCR has the potential to play a decisive role in the diagnosis and management of @entity281 in centres not applying primary antifungal mould prophylaxis.
