ASPERGILLUS PCR

Plasma: 3-4 full tubes of EDTA blood (preferably collected using strict aseptic techniques).

BAL fluid: At least 2 mL in sterile container.

There should be no sharing of sample with other tests. If sharing of samples is unavoidable, sample for Aspergillus PCR should be first sent to Molecular Lab to be aliquoted first. 

1. ​Plasma sample: As a screening assay, alongside galactomannan, for susceptible immunocompromised patients at moderate-to-high risk of developing invasive pulmonary aspergillosis (IPA), especially with neutropenic patients and patients with haematologic malignancies.
2. Plasma and/or bronchoalveolar lavage (BAL) samples: As an adjunct diagnostic test (alongside imaging, culture, and other biomarkers e.g. galactomannan assay) to assist in the diagnosis of IPA once when the disease is clinically suspected.
3. BAL samples: As an adjunct diagnostic test (alongside imaging, culture, etc) to assist in the diagnosis of chronic pulmonary aspergillosis (CPA) once when the disease is clinically suspected.
   

Refrigerate sample at 2-8°C until transfer to laboratory. Do not freeze.

Send sample at 2 - 8°C. Sample should reach the laboratory as soon as possible preferably within 4 hours after collection. Samples reaching the laboratory beyond 48 hours after collection will be rejected.

​In house real-time Polymerase Chain Reaction (PCR)

​Detected, Not Detected or Inconclusive

​1-4 days

​Tuesday and Friday

Limitations:

1. This assay detects but does not differentiate between the different species in Aspergillus genus.
2. Aspergillus species are ubiquitous in the environment, and prevention of a false positive PCR result is contingent upon careful adherence to aseptic sample collection procedures.
3. Prior or concurrent treatment of patient with anti-fungal therapy at the point of sample collection may adversely affect the performance of this assay.
4. This assay does not detect other fungal infections.

Please note that the yield of Aspergillus PCR is highest in immunocompromised patients who are suspected of having invasive pulmonary aspergillosis, while the utility of the test outside of this indication is niched.

As such, within the SGH campus, Aspergillus PCR on plasma samples will be a test which can only be ordered by Infectious Diseases doctors. Aspergillus PCR on BAL samples will also be orderable by physicians performing the BAL procedure.