Analysis of Performance of a PCR-Based Assay To Detect DNA of Aspergillus fumigatus in Whole Blood and Serum: a Comparative Study with Clinical Samples

The performance of a real-time PCR-based assay was retrospectively analyzed (according to European Organi-zation for Research and Treatment of Cancer/Mycosis Study Group criteria) in the samples of patients with invasive aspergillosis. A total of 711 serial samples (356 whole-blood and 355 serum samples) from 38 adult patients were analyzed. The Aspergillus fumigatus PCR assay results were positive for 89 of 356 (25%) whole-blood samples and 90 of 355 (25.35%) serum samples. Positive PCR results were seen in 29 of 31 (93.5%) patients for which serum was analyzed and in 31 of 33 (93.9%) cases with whole-blood specimens. Both blood and serum samples were available in 26 cases, and significant differences were not observed in this subgroup of cases. The average number of threshold cycles (CT) for positive blood samples was 37.6, and the average CT for serum was 37.4. The DNA concentration ranged between 2 and 50 fg per l of sample, with average DNA concentrations of 10.2 and 11.7 fg in positive blood and serum samples, respectively (P> 0.01). The performance of this PCR-based quantitative assay was similar for both serum and blood samples. We recommend serum samples as the most convenient hematological sample to use for Aspergillus DNA quantification when serial determinations are done. The diagnosis of invasive aspergillosis (IA) remains a major challenge. This disease is still currently the most common fungal infection in patients with hematological malignancie