The current management landscape: aspergillosis

J Antimicrob Chemother. 2016 Nov;71(suppl 2):ii23-ii29. doi: 10.1093/jac/dkw393.

Abstract

Diagnosing invasive aspergillosis (IA) has long been challenging due to the inability to culture the causal Aspergillus agent from blood or other body fluids. This shortcoming has fuelled an interest in non-culture-based diagnostic techniques such as the detection of galactomannan (GM) in blood and bronchoalveolar lavage fluid, the detection of 1,3-β-d-glucan (BDG) in blood and the detection of Aspergillus DNA by PCR-based techniques. Past decades have witnessed important improvements in our understanding of the strengths and limitations of antigen assays and in the standardization of PCR-based DNA techniques. These assays are now being incorporated into care pathways and diagnostic algorithms; they help us to steward and monitor antifungal therapies and to predict treatment outcomes.

MeSH terms

  • Aspergillus / drug effects*
  • Aspergillus / isolation & purification*
  • Biomarkers / blood
  • Bronchoalveolar Lavage Fluid / chemistry
  • DNA, Fungal / blood
  • Galactose / analogs & derivatives
  • Humans
  • Immunologic Deficiency Syndromes / immunology
  • Immunologic Deficiency Syndromes / microbiology
  • Invasive Pulmonary Aspergillosis / diagnosis*
  • Invasive Pulmonary Aspergillosis / drug therapy*
  • Invasive Pulmonary Aspergillosis / microbiology
  • Mannans / blood
  • Polymerase Chain Reaction
  • beta-Glucans / blood

Substances

  • Biomarkers
  • DNA, Fungal
  • Mannans
  • beta-Glucans
  • galactomannan
  • beta-1,3-glucan
  • Galactose