TABLE 3.
Comparison of molecular-sequencing results with fungal culture in specimens with histopathologic evidence of angioinvasion onlya
| Growth of filamentous fungi | Resultsb
|
Kappa coefficient [median (IQR)] | ||
|---|---|---|---|---|
| Culture | PCR | Concordant | ||
| Cultures collected (44 sites) [no. (%)] | ||||
| No fungi | 7 (15.9) | 7 (15.9) | 1 (2.3) | −0.019 (−0.304–0.266) |
| Any fungi | 37 (84.1) | 37 (84.1) | ||
| Fungi identified at genus levelc | 35 (79.6) | 37 (84.1) | ||
| Order Mucorales | 20 (45.5) | 33 (75.0) | 16 (36.4) | 0.087 (−0.154–0.327) |
| Saksenaea spp. | 6 (13.6) | 25 (56.8) | 4 (9.1) | 0.049 (−0.130–0.228) |
| Aspergillus spp. | 13 (29.6) | 7 (15.9) | 5 (11.3) | 0.370 (0.069–0.670) |
| Fusarium spp. | 11 (25.0) | 2 (4.6) | 2 (4.5) | 0.250 (−0.039–0.539) |
| Cultures collected within 24 h of histopathology specimen collection (41 sites) [no. (%)] | ||||
| No fungi | 6 (14.6) | 8 (19.5)d | 1 (2.4) | −0.029 (−0.316–0.257) |
| Any fungi | 35 (85.4) | 33 (80.5) | ||
| Fungi identified at genus levele | 32 (78.1) | 33 (80.5) | ||
| Order Mucorales | 18 (43.9) | 28 (68.3) | 15 (35.6) | 0.253 (−0.004–0.510) |
| Saksenaea spp. | 5 (12.2) | 20 (48.8) | 4 (9.8) | 0.155 (-0.049–0.359) |
| Aspergillus spp. | 6 (14.6) | 5 (12.2) | 3 (7.3) | 0.476 (0.084–0.868) |
| Fusarium spp. | 6 (14.6) | 1 (2.4) | 0 | −0.044 (−0.119–0.032) |
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 injury sites with observed angioinvasion and cultures collected from the same injury site at Landstuhl Regional Medical Center or U.S. hospitals (n = 44) and within 24 h of histopathology specimen collection (n = 41). Categories are independent of each other. Percentage for concordance was calculated using the total number of sites (n = 44 or 41).
Excludes Mycelia sterilia and fungi classified as “not otherwise specified.” One site with fungal culture results classified as “zygomycetes” was also excluded.
Injury sites might have had more than one specimen collected, and if so, the results were collapsed to the site level. One subject with two specimens from one injury site had one of the specimens excluded after the restriction of having a culture collected within 24 h was applied. The specimen excluded was positive for fungal growth (Aspergillus spp. and Saksenaea spp.), while the included specimen was negative.
Excludes three sites with fungal culture results classified as “zygomycetes.”