TABLE 2.
Comparison of molecular-sequencing results with fungal culture in all specimens with any positive histopathology (angioinvasion or nonvascular-tissue invasion)a
| Growth of filamentous fungi | Resultsb
|
Kappa coefficient [median (IQR)] | ||
|---|---|---|---|---|
| Culture | PCR | Concordant | ||
| Cultures collected (87 sites) [no. (%)] | ||||
| No fungi | 19 (21.8) | 30 (34.5) | 11 (12.6) | 0.248 (0.039–0.457) |
| Any fungi | 68 (78.2) | 57 (65.5) | ||
| Fungi identified at genus levelc | 63 (72.4) | 57 (65.5) | ||
| Order Mucorales | 31 (35.6) | 43 (49.4) | 21 (24.1) | 0.262 (0.067–0.457) |
| Saksenaea spp. | 8 (9.2) | 31 (35.6) | 5 (5.7) | 0.129 (−0.039–0.298) |
| Aspergillus spp. | 24 (27.6) | 12 (13.8) | 9 (10.3) | 0.387 (0.169–0.605) |
| Fusarium spp. | 15 (17.2) | 6 (6.9) | 3 (3.5) | 0.208 (−0.050–0.466) |
| Cultures collected within 24 h of histopathology specimen collection (77 sites) [no. (%)] | ||||
| No fungi | 22 (28.6) | 29 (37.7) | 14 (24.7) | 0.332 (0.115–0.549) |
| Any fungi | 55 (71.4) | 48 (62.3) | ||
| Fungi identified at genus leveld | 50 (64.9) | 48 (62.3) | ||
| Order Mucorales | 25 (32.5) | 37 (48.1) | 20 (26.0) | 0.421 (0.227–0.614) |
| Saksenaea spp. | 7 (9.1) | 26 (33.8) | 5 (6.5) | 0.187 (−0.004–0.377) |
| Aspergillus spp. | 14 (18.2) | 8 (10.4) | 5 (6.5) | 0.371 (0.093–0.650) |
| Fusarium spp. | 8 (10.4) | 3 (3.9) | 0 | −0.060 (−0.112–0.008) |
Injury sites were restricted to those that also had a culture collected. By definition, control specimens did not have any histopathology or culture evidence of a fungal infection, so data from control patients are not included.
The PCR specimens were collected only from U.S. hospitals; however, cultures were collected at various time points and at different facilities. Analysis was restricted to subsets of injury sites with tissue specimens for histopathology and cultures collected from the same injury site at Landstuhl Regional Medical Center or U.S. hospitals (n = 87) and within 24 h of histopathology specimen collection (n = 77). Categories are independent of each other. Percentage for concordance was calculated using the total number of sites (n = 87 or 77).
Excludes Mycelia sterilia and fungi classified as “not otherwise specified.” Three sites with fungal culture results classified as “zygomycetes” were also excluded.
Excludes five sites with fungal culture results classified as “zygomycetes.”