Identification of invasive fungal diseases in immunocompromised patients by combining an Aspergillus specific PCR with a multifungal DNA-microarray from primary clinical samples

Mycoses. 2015 Dec;58(12):735-45. doi: 10.1111/myc.12424. Epub 2015 Oct 26.


The increasing incidence of invasive fungal diseases (IFD), most of all invasive aspergillosis (IA) in immunocompromised patients emphasises the need to improve the diagnostic tools for detection of fungal pathogens. We investigated the diagnostic performance of a multifungal DNA-microarray detecting 15 different fungi [Aspergillus, Candida, Fusarium, Mucor, Rhizopus, Scedosporium and Trichosporon species (spp.)] in addition to an Aspergillus specific polymerase chain reaction (PCR) assay. Biopsies, bronchoalveolar lavage and peripheral blood samples of 133 immunocompromised patients (pts) were investigated by a multifungal DNA-microarray as well as a nested Aspergillus specific PCR assay. Patients had proven (n = 18), probable (n = 29), possible (n = 48) and no IFD (n = 38) and were mostly under antifungal therapy at the time of sampling. The results were compared to culture, histopathology, imaging and serology, respectively. For the non-Aspergillus IFD the microarray analysis yielded in all samples a sensitivity of 64% and a specificity of 80%. Best results for the detection of all IFD were achieved by combining DNA-microarray and Aspergillus specific PCR in biopsy samples (sensitivity 79%; specificity 71%). The molecular assays in combination identify genomic DNA of fungal pathogens and may improve identification of causative pathogens of IFD and help overcoming the diagnostic uncertainty of culture and/or histopathology findings, even during antifungal therapy.

Trial registration: NCT01902030.

Keywords: DNA-microarray; clinical samples; invasive fungal disease; multiplex fungal PCR.

Publication types

  • Evaluation Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antifungal Agents / therapeutic use
  • Aspergillosis / blood
  • Aspergillosis / diagnosis*
  • Aspergillosis / diagnostic imaging
  • Aspergillus fumigatus / genetics
  • Aspergillus fumigatus / immunology
  • Aspergillus fumigatus / isolation & purification*
  • Base Sequence
  • Biopsy, Needle
  • Bronchoalveolar Lavage
  • DNA, Fungal / isolation & purification
  • Female
  • Humans
  • Immunocompromised Host
  • Male
  • Molecular Sequence Data
  • Multiplex Polymerase Chain Reaction / methods*
  • Oligonucleotide Array Sequence Analysis / methods*
  • Radiography
  • Sensitivity and Specificity


  • Antifungal Agents
  • DNA, Fungal

Associated data