Aspergillus infections in immunocompromised patients: clinical-laboratory-molecular diagnosis and studies genotypic and phenotypic of isolates

Abstract

The identification of agents of invasive aspergillosis and possible antifungal resistance in the outcome of the disease will be analyzed in a prospective study including 300 patients of HCFMUSP with proven, probable and possible invasive aspergillosis, according to the criteria defined by EORTC/MSG. The fungi isolated from patients with colonization (50 patients) and invasive aspergillosis will be tested for antifungal susceptibility tests and for the presence of synergism and/or antagonism of the drugs. For improvement of clinical diagnosis, the accuracy of several tomography signs will be analyzed in comparison to immunological (galactomanan and β 1,3 glucan)/molecular tests, according to the period of disease diagnosis and its outcome. Proteomic assays will be performed in patients sera from patients with several forms of aspergillosis aiming to look for protein of hypha/germinative tube extracts or secretome of this fungus. New markers are necessary for a sensitive and specific immunological diagnosis of invasive aspergillosis, applicable to routine tests in medical attention, looking for a better cost-benefit-effectiveness, considering the high costs of commercial accessible tests. The usefulness of PCR will be compared to immunological tests, both in blood and in bronchoalveolar lavage. These isolates will be identified by molecular techniques, in comparison to phenotypic tests and severity and outcome of clinical disease. In this study, 400 individuals will be included, the majority with invasive aspergillosis, patients with colonization, patients with other diseases and healthy controls. (AU)