Table 1.
Performance of Aspergillus PCR in blood comparing settings with no antifungal prophylaxis versus settings with antifungal prophylaxis.
| Author | Patients Characteristics | Patients (Samples) | IPA Cases | Proportion of Patients on Antifungals at Time of PCR | Material | PCR Assay | Cut off/Cycles | Sensitivity % (95% CI) | Specificity % (95% CI) | NPV %/NLR | PPV%/PLR | DOR | Reference |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Cesaro et al. | Hematological malignancies | 62 (536) | 8 * | 42% | Whole blood–single §§ | Real time PCR | 45 | 88 | 37 | 95 | 17 | - | [97] |
| Whole blood-multiple §§ | 63 | 81 | 94 | 33 | |||||||||
| Eigl et al. | Hematological malignancies | 53 (53) | 16 * | 64% | Whole blood | Nested | - | 0 (0–19.4) | 100 (90.6–100.0) | 70 | NA | NA | |
| Boch et al. | Hematological malignancies | 133 (138) | 38 * | 67% | Whole blood | Nested | - | 8 (3–20) | 87 (70–95) | 1.07 1 | 0.58 2 | 0.54 | [62] |
| Hummel et al. | Hematological malignancies | 91 (459) | 30 * | 70% | Whole blood | Nested | 1–5 CFU/mL | 43 | - | - | - | - | [98] |
| Heldt et al. | Hematological malignancies | 106 (106) | 11 * | 80% | Serum | Nested | - | 0 (0–27.8) | 100 (93.5–100.0) | 85 | NA | NA | [99] |
| Aslan et al. | Hematological malignancies | 99 (358) | 18 * | 90% | Serum | Myc Assay | 45 | 65.0 (58.0–72.7) | 57.8 (50.2–65.4) | 51.7 | 50 | - | [100] |
| Springer et al. | Hematological malignancies | 213 (2128) | 9 * | 100% | Serum–single §§ | Real time PCR | - | 100.0 (39.8–100.0) | 27.4 (17.6–39.1) | 100 | 7.0 | 161 | [15] |
| Serum–multiple §§ | 50.0 (6.8–93.2) | 52.1 (40.0–63.9) | 95.0 | 5.4 | 1.1 | ||||||||
| Lass-Flörl et al. | Hematological malignancies or SOT | 36 (205) *** | 24 ** | 100% | Whole blood | Traditional | 34 | 44 § | 100 § | 58 § | - | - | [31] |
| Springer et al. | Hematological malignancies | 46 | 3 * | 100% | Whole blood–single §§ | Real time PCR | 60 | 55 | 75 | 64 | 67 | - | [101] |
| Whole blood–multiple §§ | 27 | 100 | 60 | 100 | |||||||||
| Buchheidt et al. | Hematological malignancies | 218 (847) | 33 ** | 0% 3 | Serum | Nested | 5 CFU/mL | 91.7 | 81.3 | 98.0 | 49.3 | - | [102] |
| Da Silva et al. | Hematological malignancies | 172 (1311) | 20 * | Whole blood | Traditional | 35 | 75.0 (50.6–90.4) | 91.9 (86.5–95.3) | 97.0 | 51.7 | - | [103] | |
| Badiee et al. | Hematological malignancies | 62 (230) | 10 * | Serum | Nested | 1 CFU/mL | 80 | 96.2 | 88.9 | 92.6 | - | [104] | |
| Springer et al. | Hematological malignancies | 213 (2128) | 17 * | Serum-single §§ | Real time PCR | 60 | 92.9 (66.1–99.8) | 73.1 (61.8–82.5) | 98.3 | 38.2 | 34.5 | [15] | |
| Serum-multiple §§ | 71.4 (41.9–91.6) | 92.3 (84.0–97.1) | 94.7 | 62.5 | 29.4 |
* proven/prob according to EORTC 2008. ** proven/prob according to EORTC 2002. *** only pts with proven/prob/poss IPA included. § for probable IPA. §§ single = one positive test required; multiple = two or more positive tests required. # at time of PCR. 1 negative likelihood ratio. 2 positive likelihood ratio. 3 explicitly mentioned that NO antifungal prophylaxis was administered.