{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T14:51:36Z","timestamp":1781189496770,"version":"3.54.1"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2019,2,8]],"date-time":"2019-02-08T00:00:00Z","timestamp":1549584000000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Diagnosis of invasive aspergillosis (IA) is challenging, particularly in high-risk patients with lung lesions other than typical according to 2008-EORTC\/MSG criteria. Even if microbiology is positive, they still remain unclassified according to 2008-EORTC\/MSG. Quantitative polymerase chain reaction (qPCR) provides new mycological documentation of IA. This retrospective study assessed Aspergillus fumigatus real time qPCR (MycoGENIE\u00ae) in BAL to diagnose IA and identify azole-resistant strains. Clinical, radiological, and microbiological data from 114 hematology patients (69% HSCT recipients; 29% on mould active agents) from years 2012-2017 were collected; and 123 BAL samples were tested with qPCR (cutoff: Ct &lt; 40) and galactomannan (GM, Platelia\u00ae, cutoff: 0.5 ODI). Patients were classified as proven\/probable, possible, and no-IA. \"Atypical-IA\" referred to patients with lesions other than typical according to 2008-EORTC\/MSG and positive mycology. Proven IA was diagnosed in two cases (1.6%), probable in 28 (22.8%), possible in 27 (22%), atypical in 14 (11.4%). qPCR was positive in 39 samples (31.7%). Sensitivity and specificity of qPCR for proven\/probable IA (vs no-IA; atypical-IA excluded) were 40% (95% confidence interval [CI]: 23\u201359) and 69% (95%CI: 55\u201381), respectively. Sensitivity of qPCR was higher when combined with GM (83%, 95%CI: 65\u201394) and in those receiving mould-active agents at BAL (61%, 95%CI: 32\u201386). One sample had TR34\/L98H mutation. In conclusion, in high-risk hematology patients with various lung lesions, A. fumigatus qPCR in BAL contributes to diagnosing IA, particularly if combined with GM and in patients receiving mould-active agents might allow detecting azole-resistant mutations in culture negative samples.<\/jats:p>","DOI":"10.1093\/mmy\/myz002","type":"journal-article","created":{"date-parts":[[2019,1,27]],"date-time":"2019-01-27T04:11:07Z","timestamp":1548562267000},"page":"987-996","source":"Crossref","is-referenced-by-count":32,"title":["Use of Aspergillus fumigatus real-time PCR in bronchoalveolar lavage samples (BAL) for diagnosis of invasive aspergillosis, including azole-resistant cases, in high risk haematology patients: the need for a combined use with galactomannan"],"prefix":"10.1093","volume":"57","author":[{"given":"Malgorzata","family":"Mikulska","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy"},{"name":"Ospedale Policlinico San Martino-IRCCS per l\u2019Oncologia, Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Furfaro","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"De Carolis","sequence":"additional","affiliation":[{"name":"Institute of Microbiology, Universit\u00e0 Cattolica del Sacro Cuore - Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Drago","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Genoa, Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Pulzato","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Genoa, Ospedale Policlinico San Martino-IRCCS per l\u2018Oncologia, Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Lucia","family":"Borghesi","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy"},{"name":"Ospedale Policlinico San Martino-IRCCS per l\u2019Oncologia, Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuela","family":"Zappulo","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy"},{"name":"Ospedale Policlinico San Martino-IRCCS per l\u2019Oncologia, Genoa, Italy"},{"name":"Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples \u201cFederico II,\u201d Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Maria","family":"Raiola","sequence":"additional","affiliation":[{"name":"Division of Hematology and Bone Marrow Transplantation, Ospedale Policlinico San Martino-IRCCS per l\u2019Oncologia, Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen Di","family":"Grazia","sequence":"additional","affiliation":[{"name":"Division of Hematology and Bone Marrow Transplantation, Ospedale Policlinico San Martino-IRCCS per l\u2019Oncologia, Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerio","family":"Del Bono","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Azienda Ospedaliera S. 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