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Journal of Clinical Microbiology, April 2000, p. 1434-1438, Vol. 38, No. 4
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Quantitative Galactomannan Detection Is Superior to PCR in Diagnosing and Monitoring Invasive Pulmonary Aspergillosis in an Experimental Rat Model

Martin J. Becker,* Siem de Marie, Diana Willemse, Henri A. Verbrugh, and Irma A. J. M. Bakker-Woudenberg

Department of Medical Microbiology and Infectious Diseases, Erasmus Medical Center Rotterdam, 3000 DR Rotterdam, The Netherlands

Received 23 September 1999/Returned for modification 1 December 1999/Accepted 15 January 2000

Two diagnostic tests, an Aspergillus-specific PCR and an enzyme-linked immunosorbent assay (ELISA) for the quantitative determination of galactomannan, were compared for diagnosing and monitoring invasive pulmonary aspergillosis. Persistently neutropenic rats with left-sided invasive pulmonary aspergillosis were sacrificed at regular intervals after inoculation. Blood samples and bronchoalveolar lavage (BAL) fluid were cultured and tested by PCR as well as by ELISA. Disseminated fungal infection in extrapulmonary organs was determined. The sensitivity of the ELISA was higher than that of the PCR on all days of measurements, in both blood and BAL fluid. Positive PCR or ELISA results in blood were not significantly associated with disseminated fungal infection. Serial testing in a separate group of rats showed consistently increasing concentrations of circulating galactomannan during the course of disease, while a positive PCR could be followed by negative results. The concentration of galactomannan was highly predictive for the time of survival (P < 0.0001). It was concluded that, in this model, quantitative galactomannan detection is superior to PCR in diagnosing and monitoring invasive pulmonary aspergillosis.

* Corresponding author. Mailing address: Department of Medical Microbiology and Infectious Diseases, Erasmus Medical Center Rotterdam, Dr. Molewaterplein 50, 3015 GE Rotterdam, The Netherlands. Phone: 31-10-4087827. Fax: 31-10-4089454. E-mail: becker{at}kmic.fgg.eur.nl.

Journal of Clinical Microbiology, April 2000, p. 1434-1438, Vol. 38, No. 4
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.


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