Document 0814
 DOCN  M95A0814
 TI    Detection of Aspergillus species DNA in bronchoalveolar lavage samples
       by competitive PCR.
 DT    9510
 AU    Bretagne S; Costa JM; Marmorat-Khuong A; Poron F; Cordonnier C; Vidaud
       M; Fleury-Feith J; Laboratoire de Parasitologie-Mycologie, Hopital Henri
       Mondor,; Creteil, France.
 SO    J Clin Microbiol. 1995 May;33(5):1164-8. Unique Identifier : AIDSLINE
       GENBANK/L37095
 AB    A competitive PCR assay involving the use of bronchoalveolar lavage
       (BAL) samples for the diagnosis of invasive pulmonary aspergillosis
       (IPA) was developed. For this purpose, a 1-kb mitochondrial DNA fragment
       of Aspergillus fumigatus was sequenced. The primers used allowed
       amplification of A. fumigatus, A. flavus, A. terreus, and A. niger DNAs
       but not DNAs of other fungi and yeasts. BAL samples from 55
       consecutively enrolled patients were tested. Three samples were excluded
       because of failure of correct amplification of the internal competitive
       control. Of 28 immunocompromised patients, 6 were PCR positive; 3 died
       of IPA and their BAL cultures yielded A. fumigatus; and 3 were culture
       negative and did not develop IPA. Of 15 human immunodeficiency
       virus-positive patients and 9 immunocompetent patients, 5 and 4,
       respectively, were both PCR positive and culture negative, and none
       developed aspergillosis. Thus, PCR confirmed IPA in three patients but
       gave positive results for 25% (12 of 49) of the patients who did not
       develop aspergillosis. The predictive value of PCR-positive results
       seems low for patients at risk for aspergillosis. Moreover, the risk of
       contamination of reaction buffers or biological samples with Aspergillus
       conidia seems high and has to be weighed in regard to the potential
       diagnostic benefit of PCR testing as a routine procedure.
 DE    Adolescence  Adult  Aged
       Aspergillosis/COMPLICATIONS/DIAGNOSIS/MICROBIOLOGY
       Aspergillus/*GENETICS/*ISOLATION & PURIF  AIDS-Related Opportunistic
       Infections/DIAGNOSIS/MICROBIOLOGY  Base Sequence  Bronchoalveolar Lavage
       Fluid/*MICROBIOLOGY  Child  Diagnostic Errors  DNA Primers/GENETICS
       DNA, Fungal/*GENETICS/*ISOLATION & PURIF  Female  Human  Lung Diseases,
       Fungal/COMPLICATIONS/DIAGNOSIS/MICROBIOLOGY  Male  Middle Age  Molecular
       Sequence Data  Opportunistic Infections/DIAGNOSIS/MICROBIOLOGY
       Polymerase Chain Reaction/*METHODS/STATISTICS & NUMER DATA  Sensitivity
       and Specificity  Support, Non-U.S. Gov't  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).