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ECIL-3 classical diagnostic procedures for the diagnosis of invasive fungal diseases in patients with leukaemia

Bone Marrow Transplantation volume 47, pages 1030–1045 (2012)Cite this article

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Abstract

Invasive fungal diseases (IFDs) continue to cause considerable morbidity and mortality in patients with haematological malignancy. Diagnosis of IFD is difficult, with the sensitivity of the gold standard tests (culture and histopathology) often reported to be low, which may at least in part be due to sub-optimal sampling or subsequent handling in the routine microbiological laboratory. Therefore, a working group of the European Conference in Infections in Leukaemia was convened in 2009 with the task of reviewing the classical diagnostic procedures and providing recommendations for their optimal use. The recommendations were presented and approved at the ECIL-3 conference in September 2009. Although new serological and molecular tests are examined in separate papers, this review focuses on sample types, microscopy and culture procedures, antifungal susceptibility testing and imaging. The performance and limitations of these procedures are discussed and recommendations are provided on when and how to use them and how to interpret the results.

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Authors and Affiliations

  1. Unit of Mycology and Parasitology, Microbiological Surveillance and Research, Statens Serum Institut, Copenhagen, Denmark

    M C Arendrup

  2. Department of Laboratory Medicine, Institute of Medical Microbiology, University Hospital, Lausanne, Switzerland

    J Bille

  3. Université Paris Descartes, Faculté de Médecine, AP-HP, Hôpital Européen Georges Pompidou, Unité de Parasitologie—Mycologie, Paris, France

    E Dannaoui

  4. Division Oncology/Haematology, Department of Medicine, Charité Universitätsmedizin, Berlin, Germany

    M Ruhnke

  5. Diagnostic and Interventional Radiology with Nuclear Medicine, Chest Clinic at University Hospital Heidelberg, Heidelberg, Germany

    C-P Heussel

  6. University College London and Department of Medical Microbiology, Centre for Clinical Microbiology, Royal Free Hospital NHS Trust, London, UK

    C Kibbler

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Competing interests

MCA has been a consultant for Astellas, Merck, Pfizer, and SpePharm, been an invited speaker for Astellas, Cephalon, Merck Sharp and Dohme, Pfizer, Schering-Plough, and Swedish Orphan and has received research funding from Astellas, Merck and Pfizer. CK has received a research grant from Gilead and honoraria for lectures and/or attendance at advisory boards for Gilead, MSD, Pfizer, Astellas and Astra Zeneca. ED has received funds for speaking from Merck and Schering, for consultancy from Merck and Astellas, and for travel from Merck, Schering, Gilead, and Astellas. MR has received research grants from Deutsche Krebshilfe/German Cancer Aid and Deutscher Stifterverband (Professor for clinical mycology in cancer patients), Pfizer, Merck/MSD, and Roche Molecular Diagnostics, is/was a consultant to Astellas, Basilea, Essex/Schering-Plough, Gilead Sciences, Janssen, Merck/MSD, Novartis, Pfizer, and Pliva, and served at the speakers’ bureau of Astellas, Gilead Sciences, Merck/MSD, and Pfizer. C-PH holds stocks in Stada and GSK, has acted as consultant for Schering-Plough, Pfizer, Basilea, Boehringer Ingelheim, Novartis, Roche and Astellas, and has been invited speaker for Gilead, Essex, Schering-Plough, AstraZeneca, Lilly, Roche, MSD, Pfizer and GSK. JB declares no conflict of interest.

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Arendrup, M., Bille, J., Dannaoui, E. et al. ECIL-3 classical diagnostic procedures for the diagnosis of invasive fungal diseases in patients with leukaemia. Bone Marrow Transplant 47, 1030–1045 (2012). https://doi.org/10.1038/bmt.2011.246

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