Martha van der Beek (LUMC)

Summary of presentation:
Invasive aspergillosis occurs an increasingly diverse patient populations and its diagnosis is a challenge for the clinical microbiologist. While in the past it was mostly recognized as a severe disease in patients with hematological disease, it is now also an established complication of severe viral respiratory infections and of various immunomodulatory therapies. The diagnosis depends on both patient risk factors, signs and symptoms, radiological abnormalities and mycological test results.
Recognizing patients at risk, signs and symptoms is complicated by the ever growing diversity of patients at risk. Mycological tests have a moderate sensitivity and specificity, especially in non-neutropenic patients and therefore a combination of various mycological tests is often performed. This both improves and complicates interpretation because if often results in conflicting test results in a single patient. Also real-life performance and interpretation of mycological tests such as galactomannan testing or PCR is often different from scientific publications, due to both technical and patient related factors. Sharing real-life data can aid in interpreting test results.
Novel diagnostic methods have been and are under development for the diagnosis of invasive aspergillosis, such as rapid antigen tests, urine based antigen tests, novel molecular diagnostic approaches, measurement of host response markers and fungal metabolites. An overview will be given on the development, performance and stage of implementation of these diagnostic modalities.