Determining the analytical specificity of PCR-based assays for the diagnosis of IA: What is Aspergillus?
Identifieur interne : 000E53 ( PubMed/Checkpoint ); précédent : 000E52; suivant : 000E54Determining the analytical specificity of PCR-based assays for the diagnosis of IA: What is Aspergillus?
Auteurs : C Oliver Morton [Australie] ; P Lewis White [Royaume-Uni] ; Rosemary A. Barnes ; Lena Klingspor [Suède] ; Manuel Cuenca-Estrella [Espagne] ; Katrien Lagrou [Belgique] ; Stéphane Bretagne [France] ; Willem Melchers [Pays-Bas] ; Carlo Mengoli [Italie] ; Angela M. Caliendo [États-Unis] ; Massimo Cogliati [Italie] ; Yvette Debets-Ossenkopp [Pays-Bas] ; Rebecca Gorton [Royaume-Uni] ; Ferry Hagen [Pays-Bas] ; Catriona Halliday [Australie] ; Petr Hamal [République tchèque] ; Kathleen Harvey-Wood [Royaume-Uni] ; Katia Jaton [Suisse] ; Gemma Johnson [Royaume-Uni] ; Sarah Kidd ; Martina Lengerova [République tchèque] ; Cornelia Lass-Florl [Autriche] ; Chris Linton [Royaume-Uni] ; Laurence Millon [France] ; C Orla Morrissey [Australie] ; Melinda Paholcsek ; Alida Fe Talento [Irlande (pays)] ; Markus Ruhnke [Allemagne] ; Birgit Willinger [Autriche] ; J Peter Donnelly [Pays-Bas] ; Juergen Loeffler [Allemagne]Source :
- Medical mycology [ 1460-2709 ] ; 2017.
Abstract
A wide array of PCR tests has been developed to aid the diagnosis of invasive aspergillosis (IA), providing technical diversity but limiting standardisation and acceptance. Methodological recommendations for testing blood samples using PCR exist, based on achieving optimal assay sensitivity to help exclude IA. Conversely, when testing more invasive samples (BAL, biopsy, CSF) emphasis is placed on confirming disease, so analytical specificity is paramount. This multicenter study examined the analytical specificity of PCR methods for detecting IA by blind testing a panel of DNA extracted from a various fungal species to explore the range of Aspergillus species that could be detected, but also potential cross reactivity with other fungal species. Positivity rates were calculated and regression analysis was performed to determine any associations between technical specifications and performance. The accuracy of Aspergillus genus specific assays was 71.8%, significantly greater (P < .0001) than assays specific for individual Aspergillus species (47.2%). For genus specific assays the most often missed species were A. lentulus (25.0%), A. versicolor (24.1%), A. terreus (16.1%), A. flavus (15.2%), A. niger (13.4%), and A. fumigatus (6.2%). There was a significant positive association between accuracy and using an Aspergillus genus PCR assay targeting the rRNA genes (P = .0011). Conversely, there was a significant association between rRNA PCR targets and false positivity (P = .0032). To conclude current Aspergillus PCR assays are better suited for detecting A. fumigatus, with inferior detection of most other Aspergillus species. The use of an Aspergillus genus specific PCR assay targeting the rRNA genes is preferential.
DOI: 10.1093/mmy/myw093
PubMed: 28339744
Affiliations:
- Allemagne, Australie, Autriche, Belgique, Espagne, France, Irlande (pays), Italie, Pays-Bas, Royaume-Uni, République tchèque, Suisse, Suède, États-Unis
- Angleterre, Berlin, Bourgogne-Franche-Comté, Communauté de Madrid, Franche-Comté, Grand Londres, Gueldre, Hollande-Septentrionale, Lombardie, Moravie, Nouvelle-Galles du Sud, Svealand, Victoria (État), Vienne (Autriche), Écosse, Île-de-France
- Amsterdam, Berlin, Besançon, Brno, Londres, Madrid, Melbourne, Milan, Nimègue, Paris, Stockholm, Sydney, Vienne (Autriche)
- Université de Londres
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Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Debets Ossenkopp, Yvette" sort="Debets Ossenkopp, Yvette" uniqKey="Debets Ossenkopp Y" first="Yvette" last="Debets-Ossenkopp">Yvette Debets-Ossenkopp</name><affiliation wicri:level="3"><nlm:affiliation>VU University Medical Centre, Amsterdam. The Netherlands.</nlm:affiliation><country>Pays-Bas</country><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName><wicri:orgArea>VU University Medical Centre</wicri:orgArea></affiliation></author><author><name sortKey="Gorton, Rebecca" sort="Gorton, Rebecca" uniqKey="Gorton R" first="Rebecca" last="Gorton">Rebecca Gorton</name><affiliation wicri:level="3"><nlm:affiliation>Royal Free Hospital, London, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Royal Free Hospital, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Hagen, Ferry" sort="Hagen, Ferry" uniqKey="Hagen F" first="Ferry" last="Hagen">Ferry Hagen</name><affiliation wicri:level="3"><nlm:affiliation>Canisius-Wilhelmina Hospital, Nijmegen. 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UK.</nlm:affiliation><country>Royaume-Uni</country><placeName><region type="country">Écosse</region></placeName><wicri:cityArea>Southern General Hospital, Glasgow</wicri:cityArea></affiliation></author><author><name sortKey="Jaton, Katia" sort="Jaton, Katia" uniqKey="Jaton K" first="Katia" last="Jaton">Katia Jaton</name><affiliation wicri:level="1"><nlm:affiliation>Institute of Microbiology, University Hospital of Lausanne, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Institute of Microbiology, University Hospital of Lausanne</wicri:regionArea><wicri:noRegion>University Hospital of Lausanne</wicri:noRegion></affiliation></author><author><name sortKey="Johnson, Gemma" sort="Johnson, Gemma" uniqKey="Johnson G" first="Gemma" last="Johnson">Gemma Johnson</name><affiliation wicri:level="4"><nlm:affiliation>Blizard Institute of Cell and Molecular Science, Queen Mary University of London, London, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Blizard Institute of Cell and Molecular Science, Queen Mary University of London, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region><settlement type="city">Londres</settlement></placeName><orgName type="university">Université de Londres</orgName></affiliation></author><author><name sortKey="Kidd, Sarah" sort="Kidd, Sarah" uniqKey="Kidd S" first="Sarah" last="Kidd">Sarah Kidd</name><affiliation><nlm:affiliation>National Mycology Reference Centre, SA Pathology, Adelaide. Australia.</nlm:affiliation><wicri:noCountry code="subField">Adelaide</wicri:noCountry></affiliation></author><author><name sortKey="Lengerova, Martina" sort="Lengerova, Martina" uniqKey="Lengerova M" first="Martina" last="Lengerova">Martina Lengerova</name><affiliation wicri:level="3"><nlm:affiliation>Department of Internal Medicine - Hematology and Oncology, University Hospital Brno, Brno, Czech Republic.</nlm:affiliation><country xml:lang="fr">République tchèque</country><wicri:regionArea>Department of Internal Medicine - Hematology and Oncology, University Hospital Brno, Brno</wicri:regionArea><placeName><settlement type="city">Brno</settlement><region>Moravie</region></placeName></affiliation></author><author><name sortKey="Lass Florl, Cornelia" sort="Lass Florl, Cornelia" uniqKey="Lass Florl C" first="Cornelia" last="Lass-Florl">Cornelia Lass-Florl</name><affiliation wicri:level="1"><nlm:affiliation>Innsbruck Medical University, Innsbruck, Austria.</nlm:affiliation><country xml:lang="fr">Autriche</country><wicri:regionArea>Innsbruck Medical University, Innsbruck</wicri:regionArea><wicri:noRegion>Innsbruck</wicri:noRegion></affiliation></author><author><name sortKey="Linton, Chris" sort="Linton, Chris" uniqKey="Linton C" first="Chris" last="Linton">Chris Linton</name><affiliation wicri:level="1"><nlm:affiliation>UK Mycology Reference Lab, Public Health England, Bristol, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>UK Mycology Reference Lab, Public Health England, Bristol</wicri:regionArea><wicri:noRegion>Bristol</wicri:noRegion></affiliation></author><author><name sortKey="Millon, Laurence" sort="Millon, Laurence" uniqKey="Millon L" first="Laurence" last="Millon">Laurence Millon</name><affiliation wicri:level="3"><nlm:affiliation>Laboratoire de Parasitologie-Mycologie Centre Hospitalier Universitaire, Besançon, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Laboratoire de Parasitologie-Mycologie Centre Hospitalier Universitaire, Besançon</wicri:regionArea><placeName><region type="region">Bourgogne-Franche-Comté</region><region type="old region">Franche-Comté</region><settlement type="city">Besançon</settlement></placeName></affiliation></author><author><name sortKey="Morrissey, C Orla" sort="Morrissey, C Orla" uniqKey="Morrissey C" first="C Orla" last="Morrissey">C Orla Morrissey</name><affiliation wicri:level="3"><nlm:affiliation>Alfred Health and Monash University, Melbourne, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Alfred Health and Monash University, Melbourne</wicri:regionArea><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Paholcsek, Melinda" sort="Paholcsek, Melinda" uniqKey="Paholcsek M" first="Melinda" last="Paholcsek">Melinda Paholcsek</name><affiliation><nlm:affiliation>University of Debrecen Medical and Health Science Center, Debrecen. Hungary.</nlm:affiliation><wicri:noCountry code="subField">Debrecen</wicri:noCountry></affiliation></author><author><name sortKey="Talento, Alida Fe" sort="Talento, Alida Fe" uniqKey="Talento A" first="Alida Fe" last="Talento">Alida Fe Talento</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Microbiology, Trinity College, Dublin, Ireland.</nlm:affiliation><country xml:lang="fr">Irlande (pays)</country><wicri:regionArea>Department of Clinical Microbiology, Trinity College, Dublin</wicri:regionArea><wicri:noRegion>Dublin</wicri:noRegion></affiliation></author><author><name sortKey="Ruhnke, Markus" sort="Ruhnke, Markus" uniqKey="Ruhnke M" first="Markus" last="Ruhnke">Markus Ruhnke</name><affiliation wicri:level="3"><nlm:affiliation>Charité Medical School, University of Berlin, Berlin. Germany.</nlm:affiliation><country>Allemagne</country><placeName><settlement type="city">Berlin</settlement><region type="land" nuts="2">Berlin</region></placeName><wicri:orgArea>Charité Medical School, University of Berlin</wicri:orgArea></affiliation></author><author><name sortKey="Willinger, Birgit" sort="Willinger, Birgit" uniqKey="Willinger B" first="Birgit" last="Willinger">Birgit Willinger</name><affiliation wicri:level="3"><nlm:affiliation>Medical University of Vienna, Vienna, Austria.</nlm:affiliation><country xml:lang="fr">Autriche</country><wicri:regionArea>Medical University of Vienna, Vienna</wicri:regionArea><placeName><settlement type="city">Vienne (Autriche)</settlement><region nuts="2" type="province">Vienne (Autriche)</region></placeName></affiliation></author><author><name sortKey="Donnelly, J Peter" sort="Donnelly, J Peter" uniqKey="Donnelly J" first="J Peter" last="Donnelly">J Peter Donnelly</name><affiliation wicri:level="3"><nlm:affiliation>Radboud University Medical Centre, Nijmegen, Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Radboud University Medical Centre, Nijmegen</wicri:regionArea><placeName><settlement type="city">Nimègue</settlement><region type="province" nuts="2">Gueldre</region></placeName></affiliation></author><author><name sortKey="Loeffler, Juergen" sort="Loeffler, Juergen" uniqKey="Loeffler J" first="Juergen" last="Loeffler">Juergen Loeffler</name><affiliation wicri:level="1"><nlm:affiliation>Wuerzburg University, Wuerzburg, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Wuerzburg University, Wuerzburg</wicri:regionArea><wicri:noRegion>Wuerzburg</wicri:noRegion><wicri:noRegion>Wuerzburg</wicri:noRegion><wicri:noRegion>Wuerzburg</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2017">2017</date><idno type="RBID">pubmed:28339744</idno><idno type="pmid">28339744</idno><idno type="doi">10.1093/mmy/myw093</idno><idno type="wicri:Area/PubMed/Corpus">000A88</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000A88</idno><idno type="wicri:Area/PubMed/Curation">000A85</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">000A85</idno><idno type="wicri:Area/PubMed/Checkpoint">000A85</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">000A85</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Determining the analytical specificity of PCR-based assays for the diagnosis of IA: What is Aspergillus?</title><author><name sortKey="Morton, C Oliver" sort="Morton, C Oliver" uniqKey="Morton C" first="C Oliver" last="Morton">C Oliver Morton</name><affiliation wicri:level="3"><nlm:affiliation>Western Sydney University, Sydney, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Western Sydney University, Sydney</wicri:regionArea><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author><author><name sortKey="White, P Lewis" sort="White, P Lewis" uniqKey="White P" first="P Lewis" last="White">P Lewis White</name><affiliation wicri:level="1"><nlm:affiliation>Public Health Wales Microbiology Cardiff, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Public Health Wales Microbiology Cardiff</wicri:regionArea></affiliation></author><author><name sortKey="Barnes, Rosemary A" sort="Barnes, Rosemary A" uniqKey="Barnes R" first="Rosemary A" last="Barnes">Rosemary A. Barnes</name><affiliation><nlm:affiliation>Cardiff University School of Medicine, Cardiff.</nlm:affiliation><wicri:noCountry code="subField">Cardiff</wicri:noCountry></affiliation></author><author><name sortKey="Klingspor, Lena" sort="Klingspor, Lena" uniqKey="Klingspor L" first="Lena" last="Klingspor">Lena Klingspor</name><affiliation wicri:level="3"><nlm:affiliation>Karolinska University Hospital, Stockholm, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Karolinska University Hospital, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Cuenca Estrella, Manuel" sort="Cuenca Estrella, Manuel" uniqKey="Cuenca Estrella M" first="Manuel" last="Cuenca-Estrella">Manuel Cuenca-Estrella</name><affiliation wicri:level="3"><nlm:affiliation>Spanish National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Spanish National Centre for Microbiology, Instituto de Salud Carlos III, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Lagrou, Katrien" sort="Lagrou, Katrien" uniqKey="Lagrou K" first="Katrien" last="Lagrou">Katrien Lagrou</name><affiliation wicri:level="1"><nlm:affiliation>University Hospitals Leuven, Department of Laboratory Medicine and National Reference Center for Mycosis, Leuven, Belgium, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>University Hospitals Leuven, Department of Laboratory Medicine and National Reference Center for Mycosis, Leuven, Belgium</wicri:regionArea><wicri:noRegion>Belgium</wicri:noRegion></affiliation></author><author><name sortKey="Bretagne, Stephane" sort="Bretagne, Stephane" uniqKey="Bretagne S" first="Stéphane" last="Bretagne">Stéphane Bretagne</name><affiliation wicri:level="3"><nlm:affiliation>Paris Diderot, Sorbonne Paris Cité University, Faculty of Medicine, Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Paris Diderot, Sorbonne Paris Cité University, Faculty of Medicine, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Melchers, Willem" sort="Melchers, Willem" uniqKey="Melchers W" first="Willem" last="Melchers">Willem Melchers</name><affiliation wicri:level="3"><nlm:affiliation>Radboud University Medical Centre, Nijmegen, Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Radboud University Medical Centre, Nijmegen</wicri:regionArea><placeName><settlement type="city">Nimègue</settlement><region type="province" nuts="2">Gueldre</region></placeName></affiliation></author><author><name sortKey="Mengoli, Carlo" sort="Mengoli, Carlo" uniqKey="Mengoli C" first="Carlo" last="Mengoli">Carlo Mengoli</name><affiliation wicri:level="1"><nlm:affiliation>University of Padua, Padua, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>University of Padua, Padua</wicri:regionArea><wicri:noRegion>Padua</wicri:noRegion></affiliation></author><author><name sortKey="Caliendo, Angela M" sort="Caliendo, Angela M" uniqKey="Caliendo A" first="Angela M" last="Caliendo">Angela M. Caliendo</name><affiliation wicri:level="1"><nlm:affiliation>Department of Medicine, Alpert Medical School of Brown University, Providence, Rhode Island and Aspergillus Technology Consortium, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Medicine, Alpert Medical School of Brown University, Providence, Rhode Island and Aspergillus Technology Consortium</wicri:regionArea><wicri:noRegion>Rhode Island and Aspergillus Technology Consortium</wicri:noRegion></affiliation></author><author><name sortKey="Cogliati, Massimo" sort="Cogliati, Massimo" uniqKey="Cogliati M" first="Massimo" last="Cogliati">Massimo Cogliati</name><affiliation wicri:level="3"><nlm:affiliation>Dip. Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Dip. Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Debets Ossenkopp, Yvette" sort="Debets Ossenkopp, Yvette" uniqKey="Debets Ossenkopp Y" first="Yvette" last="Debets-Ossenkopp">Yvette Debets-Ossenkopp</name><affiliation wicri:level="3"><nlm:affiliation>VU University Medical Centre, Amsterdam. The Netherlands.</nlm:affiliation><country>Pays-Bas</country><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName><wicri:orgArea>VU University Medical Centre</wicri:orgArea></affiliation></author><author><name sortKey="Gorton, Rebecca" sort="Gorton, Rebecca" uniqKey="Gorton R" first="Rebecca" last="Gorton">Rebecca Gorton</name><affiliation wicri:level="3"><nlm:affiliation>Royal Free Hospital, London, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Royal Free Hospital, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Hagen, Ferry" sort="Hagen, Ferry" uniqKey="Hagen F" first="Ferry" last="Hagen">Ferry Hagen</name><affiliation wicri:level="3"><nlm:affiliation>Canisius-Wilhelmina Hospital, Nijmegen. The Netherlands.</nlm:affiliation><country>Pays-Bas</country><placeName><settlement type="city">Nimègue</settlement><region type="province" nuts="2">Gueldre</region></placeName><wicri:orgArea>Canisius-Wilhelmina Hospital</wicri:orgArea></affiliation></author><author><name sortKey="Halliday, Catriona" sort="Halliday, Catriona" uniqKey="Halliday C" first="Catriona" last="Halliday">Catriona Halliday</name><affiliation wicri:level="1"><nlm:affiliation>Clinical Mycology Reference Laboratory, Pathology West, Westmead, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Clinical Mycology Reference Laboratory, Pathology West, Westmead</wicri:regionArea><wicri:noRegion>Westmead</wicri:noRegion></affiliation></author><author><name sortKey="Hamal, Petr" sort="Hamal, Petr" uniqKey="Hamal P" first="Petr" last="Hamal">Petr Hamal</name><affiliation wicri:level="1"><nlm:affiliation>Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic.</nlm:affiliation><country xml:lang="fr">République tchèque</country><wicri:regionArea>Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University Olomouc</wicri:regionArea><wicri:noRegion>Palacky University Olomouc</wicri:noRegion></affiliation></author><author><name sortKey="Harvey Wood, Kathleen" sort="Harvey Wood, Kathleen" uniqKey="Harvey Wood K" first="Kathleen" last="Harvey-Wood">Kathleen Harvey-Wood</name><affiliation wicri:level="2"><nlm:affiliation>Southern General Hospital, Glasgow, Scotland. UK.</nlm:affiliation><country>Royaume-Uni</country><placeName><region type="country">Écosse</region></placeName><wicri:cityArea>Southern General Hospital, Glasgow</wicri:cityArea></affiliation></author><author><name sortKey="Jaton, Katia" sort="Jaton, Katia" uniqKey="Jaton K" first="Katia" last="Jaton">Katia Jaton</name><affiliation wicri:level="1"><nlm:affiliation>Institute of Microbiology, University Hospital of Lausanne, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>Institute of Microbiology, University Hospital of Lausanne</wicri:regionArea><wicri:noRegion>University Hospital of Lausanne</wicri:noRegion></affiliation></author><author><name sortKey="Johnson, Gemma" sort="Johnson, Gemma" uniqKey="Johnson G" first="Gemma" last="Johnson">Gemma Johnson</name><affiliation wicri:level="4"><nlm:affiliation>Blizard Institute of Cell and Molecular Science, Queen Mary University of London, London, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Blizard Institute of Cell and Molecular Science, Queen Mary University of London, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region><settlement type="city">Londres</settlement></placeName><orgName type="university">Université de Londres</orgName></affiliation></author><author><name sortKey="Kidd, Sarah" sort="Kidd, Sarah" uniqKey="Kidd S" first="Sarah" last="Kidd">Sarah Kidd</name><affiliation><nlm:affiliation>National Mycology Reference Centre, SA Pathology, Adelaide. Australia.</nlm:affiliation><wicri:noCountry code="subField">Adelaide</wicri:noCountry></affiliation></author><author><name sortKey="Lengerova, Martina" sort="Lengerova, Martina" uniqKey="Lengerova M" first="Martina" last="Lengerova">Martina Lengerova</name><affiliation wicri:level="3"><nlm:affiliation>Department of Internal Medicine - Hematology and Oncology, University Hospital Brno, Brno, Czech Republic.</nlm:affiliation><country xml:lang="fr">République tchèque</country><wicri:regionArea>Department of Internal Medicine - Hematology and Oncology, University Hospital Brno, Brno</wicri:regionArea><placeName><settlement type="city">Brno</settlement><region>Moravie</region></placeName></affiliation></author><author><name sortKey="Lass Florl, Cornelia" sort="Lass Florl, Cornelia" uniqKey="Lass Florl C" first="Cornelia" last="Lass-Florl">Cornelia Lass-Florl</name><affiliation wicri:level="1"><nlm:affiliation>Innsbruck Medical University, Innsbruck, Austria.</nlm:affiliation><country xml:lang="fr">Autriche</country><wicri:regionArea>Innsbruck Medical University, Innsbruck</wicri:regionArea><wicri:noRegion>Innsbruck</wicri:noRegion></affiliation></author><author><name sortKey="Linton, Chris" sort="Linton, Chris" uniqKey="Linton C" first="Chris" last="Linton">Chris Linton</name><affiliation wicri:level="1"><nlm:affiliation>UK Mycology Reference Lab, Public Health England, Bristol, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>UK Mycology Reference Lab, Public Health England, Bristol</wicri:regionArea><wicri:noRegion>Bristol</wicri:noRegion></affiliation></author><author><name sortKey="Millon, Laurence" sort="Millon, Laurence" uniqKey="Millon L" first="Laurence" last="Millon">Laurence Millon</name><affiliation wicri:level="3"><nlm:affiliation>Laboratoire de Parasitologie-Mycologie Centre Hospitalier Universitaire, Besançon, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Laboratoire de Parasitologie-Mycologie Centre Hospitalier Universitaire, Besançon</wicri:regionArea><placeName><region type="region">Bourgogne-Franche-Comté</region><region type="old region">Franche-Comté</region><settlement type="city">Besançon</settlement></placeName></affiliation></author><author><name sortKey="Morrissey, C Orla" sort="Morrissey, C Orla" uniqKey="Morrissey C" first="C Orla" last="Morrissey">C Orla Morrissey</name><affiliation wicri:level="3"><nlm:affiliation>Alfred Health and Monash University, Melbourne, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Alfred Health and Monash University, Melbourne</wicri:regionArea><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Paholcsek, Melinda" sort="Paholcsek, Melinda" uniqKey="Paholcsek M" first="Melinda" last="Paholcsek">Melinda Paholcsek</name><affiliation><nlm:affiliation>University of Debrecen Medical and Health Science Center, Debrecen. Hungary.</nlm:affiliation><wicri:noCountry code="subField">Debrecen</wicri:noCountry></affiliation></author><author><name sortKey="Talento, Alida Fe" sort="Talento, Alida Fe" uniqKey="Talento A" first="Alida Fe" last="Talento">Alida Fe Talento</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Microbiology, Trinity College, Dublin, Ireland.</nlm:affiliation><country xml:lang="fr">Irlande (pays)</country><wicri:regionArea>Department of Clinical Microbiology, Trinity College, Dublin</wicri:regionArea><wicri:noRegion>Dublin</wicri:noRegion></affiliation></author><author><name sortKey="Ruhnke, Markus" sort="Ruhnke, Markus" uniqKey="Ruhnke M" first="Markus" last="Ruhnke">Markus Ruhnke</name><affiliation wicri:level="3"><nlm:affiliation>Charité Medical School, University of Berlin, Berlin. Germany.</nlm:affiliation><country>Allemagne</country><placeName><settlement type="city">Berlin</settlement><region type="land" nuts="2">Berlin</region></placeName><wicri:orgArea>Charité Medical School, University of Berlin</wicri:orgArea></affiliation></author><author><name sortKey="Willinger, Birgit" sort="Willinger, Birgit" uniqKey="Willinger B" first="Birgit" last="Willinger">Birgit Willinger</name><affiliation wicri:level="3"><nlm:affiliation>Medical University of Vienna, Vienna, Austria.</nlm:affiliation><country xml:lang="fr">Autriche</country><wicri:regionArea>Medical University of Vienna, Vienna</wicri:regionArea><placeName><settlement type="city">Vienne (Autriche)</settlement><region nuts="2" type="province">Vienne (Autriche)</region></placeName></affiliation></author><author><name sortKey="Donnelly, J Peter" sort="Donnelly, J Peter" uniqKey="Donnelly J" first="J Peter" last="Donnelly">J Peter Donnelly</name><affiliation wicri:level="3"><nlm:affiliation>Radboud University Medical Centre, Nijmegen, Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Radboud University Medical Centre, Nijmegen</wicri:regionArea><placeName><settlement type="city">Nimègue</settlement><region type="province" nuts="2">Gueldre</region></placeName></affiliation></author><author><name sortKey="Loeffler, Juergen" sort="Loeffler, Juergen" uniqKey="Loeffler J" first="Juergen" last="Loeffler">Juergen Loeffler</name><affiliation wicri:level="1"><nlm:affiliation>Wuerzburg University, Wuerzburg, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Wuerzburg University, Wuerzburg</wicri:regionArea><wicri:noRegion>Wuerzburg</wicri:noRegion><wicri:noRegion>Wuerzburg</wicri:noRegion><wicri:noRegion>Wuerzburg</wicri:noRegion></affiliation></author></analytic><series><title level="j">Medical mycology</title><idno type="eISSN">1460-2709</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">A wide array of PCR tests has been developed to aid the diagnosis of invasive aspergillosis (IA), providing technical diversity but limiting standardisation and acceptance. Methodological recommendations for testing blood samples using PCR exist, based on achieving optimal assay sensitivity to help exclude IA. Conversely, when testing more invasive samples (BAL, biopsy, CSF) emphasis is placed on confirming disease, so analytical specificity is paramount. This multicenter study examined the analytical specificity of PCR methods for detecting IA by blind testing a panel of DNA extracted from a various fungal species to explore the range of Aspergillus species that could be detected, but also potential cross reactivity with other fungal species. Positivity rates were calculated and regression analysis was performed to determine any associations between technical specifications and performance. The accuracy of Aspergillus genus specific assays was 71.8%, significantly greater (P < .0001) than assays specific for individual Aspergillus species (47.2%). For genus specific assays the most often missed species were A. lentulus (25.0%), A. versicolor (24.1%), A. terreus (16.1%), A. flavus (15.2%), A. niger (13.4%), and A. fumigatus (6.2%). There was a significant positive association between accuracy and using an Aspergillus genus PCR assay targeting the rRNA genes (P = .0011). Conversely, there was a significant association between rRNA PCR targets and false positivity (P = .0032). To conclude current Aspergillus PCR assays are better suited for detecting A. fumigatus, with inferior detection of most other Aspergillus species. The use of an Aspergillus genus specific PCR assay targeting the rRNA genes is preferential.</div></front></TEI><pubmed><MedlineCitation Status="In-Process" Owner="NLM"><PMID Version="1">28339744</PMID><DateCreated><Year>2017</Year><Month>03</Month><Day>24</Day></DateCreated><DateRevised><Year>2017</Year><Month>05</Month><Day>16</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1460-2709</ISSN><JournalIssue CitedMedium="Internet"><Volume>55</Volume><Issue>4</Issue><PubDate><Year>2017</Year><Month>Jun</Month><Day>01</Day></PubDate></JournalIssue><Title>Medical mycology</Title><ISOAbbreviation>Med. Mycol.</ISOAbbreviation></Journal><ArticleTitle>Determining the analytical specificity of PCR-based assays for the diagnosis of IA: What is Aspergillus?</ArticleTitle><Pagination><MedlinePgn>402-413</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1093/mmy/myw093</ELocationID><Abstract><AbstractText>A wide array of PCR tests has been developed to aid the diagnosis of invasive aspergillosis (IA), providing technical diversity but limiting standardisation and acceptance. Methodological recommendations for testing blood samples using PCR exist, based on achieving optimal assay sensitivity to help exclude IA. Conversely, when testing more invasive samples (BAL, biopsy, CSF) emphasis is placed on confirming disease, so analytical specificity is paramount. This multicenter study examined the analytical specificity of PCR methods for detecting IA by blind testing a panel of DNA extracted from a various fungal species to explore the range of Aspergillus species that could be detected, but also potential cross reactivity with other fungal species. Positivity rates were calculated and regression analysis was performed to determine any associations between technical specifications and performance. The accuracy of Aspergillus genus specific assays was 71.8%, significantly greater (P < .0001) than assays specific for individual Aspergillus species (47.2%). For genus specific assays the most often missed species were A. lentulus (25.0%), A. versicolor (24.1%), A. terreus (16.1%), A. flavus (15.2%), A. niger (13.4%), and A. fumigatus (6.2%). There was a significant positive association between accuracy and using an Aspergillus genus PCR assay targeting the rRNA genes (P = .0011). Conversely, there was a significant association between rRNA PCR targets and false positivity (P = .0032). To conclude current Aspergillus PCR assays are better suited for detecting A. fumigatus, with inferior detection of most other Aspergillus species. The use of an Aspergillus genus specific PCR assay targeting the rRNA genes is preferential.</AbstractText><CopyrightInformation>© The Author 2016. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Morton</LastName><ForeName>C Oliver</ForeName><Initials>CO</Initials><AffiliationInfo><Affiliation>Western Sydney University, Sydney, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>White</LastName><ForeName>P Lewis</ForeName><Initials>PL</Initials><AffiliationInfo><Affiliation>Public Health Wales Microbiology Cardiff, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Barnes</LastName><ForeName>Rosemary A</ForeName><Initials>RA</Initials><AffiliationInfo><Affiliation>Cardiff University School of Medicine, Cardiff.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Klingspor</LastName><ForeName>Lena</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Karolinska University Hospital, Stockholm, Sweden.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cuenca-Estrella</LastName><ForeName>Manuel</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Spanish National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lagrou</LastName><ForeName>Katrien</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>University Hospitals Leuven, Department of Laboratory Medicine and National Reference Center for Mycosis, Leuven, Belgium, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bretagne</LastName><ForeName>Stéphane</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Paris Diderot, Sorbonne Paris Cité University, Faculty of Medicine, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Melchers</LastName><ForeName>Willem</ForeName><Initials>W</Initials><AffiliationInfo><Affiliation>Radboud University Medical Centre, Nijmegen, Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mengoli</LastName><ForeName>Carlo</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>University of Padua, Padua, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Caliendo</LastName><ForeName>Angela M</ForeName><Initials>AM</Initials><AffiliationInfo><Affiliation>Department of Medicine, Alpert Medical School of Brown University, Providence, Rhode Island and Aspergillus Technology Consortium, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cogliati</LastName><ForeName>Massimo</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Dip. Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Debets-Ossenkopp</LastName><ForeName>Yvette</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>VU University Medical Centre, Amsterdam. The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gorton</LastName><ForeName>Rebecca</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Royal Free Hospital, London, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hagen</LastName><ForeName>Ferry</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Canisius-Wilhelmina Hospital, Nijmegen. The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Halliday</LastName><ForeName>Catriona</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Clinical Mycology Reference Laboratory, Pathology West, Westmead, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hamal</LastName><ForeName>Petr</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Department of Microbiology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Harvey-Wood</LastName><ForeName>Kathleen</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Southern General Hospital, Glasgow, Scotland. UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jaton</LastName><ForeName>Katia</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Institute of Microbiology, University Hospital of Lausanne, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Johnson</LastName><ForeName>Gemma</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Blizard Institute of Cell and Molecular Science, Queen Mary University of London, London, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kidd</LastName><ForeName>Sarah</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>National Mycology Reference Centre, SA Pathology, Adelaide. Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lengerova</LastName><ForeName>Martina</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Internal Medicine - Hematology and Oncology, University Hospital Brno, Brno, Czech Republic.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lass-Florl</LastName><ForeName>Cornelia</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Innsbruck Medical University, Innsbruck, Austria.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Linton</LastName><ForeName>Chris</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>UK Mycology Reference Lab, Public Health England, Bristol, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Millon</LastName><ForeName>Laurence</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Laboratoire de Parasitologie-Mycologie Centre Hospitalier Universitaire, Besançon, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Morrissey</LastName><ForeName>C Orla</ForeName><Initials>CO</Initials><AffiliationInfo><Affiliation>Alfred Health and Monash University, Melbourne, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Paholcsek</LastName><ForeName>Melinda</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>University of Debrecen Medical and Health Science Center, Debrecen. Hungary.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Talento</LastName><ForeName>Alida Fe</ForeName><Initials>AF</Initials><AffiliationInfo><Affiliation>Department of Clinical Microbiology, Trinity College, Dublin, Ireland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ruhnke</LastName><ForeName>Markus</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Charité Medical School, University of Berlin, Berlin. Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Willinger</LastName><ForeName>Birgit</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Medical University of Vienna, Vienna, Austria.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Donnelly</LastName><ForeName>J Peter</ForeName><Initials>JP</Initials><AffiliationInfo><Affiliation>Radboud University Medical Centre, Nijmegen, Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Loeffler</LastName><ForeName>Juergen</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Wuerzburg University, Wuerzburg, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><CollectiveName>EAPCRI</CollectiveName></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Med Mycol</MedlineTA><NlmUniqueID>9815835</NlmUniqueID><ISSNLinking>1369-3786</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Aspergillus PCR</Keyword><Keyword MajorTopicYN="N">analytical specificity</Keyword><Keyword MajorTopicYN="N">cross reactivity</Keyword><Keyword MajorTopicYN="N">detection range</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2016</Year><Month>03</Month><Day>10</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2016</Year><Month>09</Month><Day>27</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2016</Year><Month>1</Month><Day>1</Day><Hour>0</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2016</Year><Month>1</Month><Day>1</Day><Hour>0</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2017</Year><Month>3</Month><Day>25</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">28339744</ArticleId><ArticleId IdType="pii">2628999</ArticleId><ArticleId IdType="doi">10.1093/mmy/myw093</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>Autriche</li><li>Belgique</li><li>Espagne</li><li>France</li><li>Irlande (pays)</li><li>Italie</li><li>Pays-Bas</li><li>Royaume-Uni</li><li>République tchèque</li><li>Suisse</li><li>Suède</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Berlin</li><li>Bourgogne-Franche-Comté</li><li>Communauté de Madrid</li><li>Franche-Comté</li><li>Grand Londres</li><li>Gueldre</li><li>Hollande-Septentrionale</li><li>Lombardie</li><li>Moravie</li><li>Nouvelle-Galles du Sud</li><li>Svealand</li><li>Victoria (État)</li><li>Vienne (Autriche)</li><li>Écosse</li><li>Île-de-France</li></region><settlement><li>Amsterdam</li><li>Berlin</li><li>Besançon</li><li>Brno</li><li>Londres</li><li>Madrid</li><li>Melbourne</li><li>Milan</li><li>Nimègue</li><li>Paris</li><li>Stockholm</li><li>Sydney</li><li>Vienne (Autriche)</li></settlement><orgName><li>Université de Londres</li></orgName></list><tree><noCountry><name sortKey="Barnes, Rosemary A" sort="Barnes, Rosemary A" uniqKey="Barnes R" first="Rosemary A" last="Barnes">Rosemary A. Barnes</name><name sortKey="Kidd, Sarah" sort="Kidd, Sarah" uniqKey="Kidd S" first="Sarah" last="Kidd">Sarah Kidd</name><name sortKey="Paholcsek, Melinda" sort="Paholcsek, Melinda" uniqKey="Paholcsek M" first="Melinda" last="Paholcsek">Melinda Paholcsek</name></noCountry><country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="Morton, C Oliver" sort="Morton, C Oliver" uniqKey="Morton C" first="C Oliver" last="Morton">C Oliver Morton</name></region><name sortKey="Halliday, Catriona" sort="Halliday, Catriona" uniqKey="Halliday C" first="Catriona" last="Halliday">Catriona Halliday</name><name sortKey="Morrissey, C Orla" sort="Morrissey, C Orla" uniqKey="Morrissey C" first="C Orla" last="Morrissey">C Orla Morrissey</name></country><country name="Royaume-Uni"><noRegion><name sortKey="White, P Lewis" sort="White, P Lewis" uniqKey="White P" first="P Lewis" last="White">P Lewis White</name></noRegion><name sortKey="Gorton, Rebecca" sort="Gorton, Rebecca" uniqKey="Gorton R" first="Rebecca" last="Gorton">Rebecca Gorton</name><name sortKey="Harvey Wood, Kathleen" sort="Harvey Wood, Kathleen" uniqKey="Harvey Wood K" first="Kathleen" last="Harvey-Wood">Kathleen Harvey-Wood</name><name sortKey="Johnson, Gemma" sort="Johnson, Gemma" uniqKey="Johnson G" first="Gemma" last="Johnson">Gemma Johnson</name><name sortKey="Linton, Chris" sort="Linton, Chris" uniqKey="Linton C" first="Chris" last="Linton">Chris Linton</name></country><country name="Suède"><region name="Svealand"><name sortKey="Klingspor, Lena" sort="Klingspor, Lena" uniqKey="Klingspor L" first="Lena" last="Klingspor">Lena Klingspor</name></region></country><country name="Espagne"><region name="Communauté de Madrid"><name sortKey="Cuenca Estrella, Manuel" sort="Cuenca Estrella, Manuel" uniqKey="Cuenca Estrella M" first="Manuel" last="Cuenca-Estrella">Manuel Cuenca-Estrella</name></region></country><country name="Belgique"><noRegion><name sortKey="Lagrou, Katrien" sort="Lagrou, Katrien" uniqKey="Lagrou K" first="Katrien" last="Lagrou">Katrien Lagrou</name></noRegion></country><country name="France"><region name="Île-de-France"><name sortKey="Bretagne, Stephane" sort="Bretagne, Stephane" uniqKey="Bretagne S" first="Stéphane" last="Bretagne">Stéphane Bretagne</name></region><name sortKey="Millon, Laurence" sort="Millon, Laurence" uniqKey="Millon L" first="Laurence" last="Millon">Laurence Millon</name></country><country name="Pays-Bas"><region name="Gueldre"><name sortKey="Melchers, Willem" sort="Melchers, Willem" uniqKey="Melchers W" first="Willem" last="Melchers">Willem Melchers</name></region><name sortKey="Debets Ossenkopp, Yvette" sort="Debets Ossenkopp, Yvette" uniqKey="Debets Ossenkopp Y" first="Yvette" last="Debets-Ossenkopp">Yvette Debets-Ossenkopp</name><name sortKey="Donnelly, J Peter" sort="Donnelly, J Peter" uniqKey="Donnelly J" first="J Peter" last="Donnelly">J Peter Donnelly</name><name sortKey="Hagen, Ferry" sort="Hagen, Ferry" uniqKey="Hagen F" first="Ferry" last="Hagen">Ferry Hagen</name></country><country name="Italie"><noRegion><name sortKey="Mengoli, Carlo" sort="Mengoli, Carlo" uniqKey="Mengoli C" first="Carlo" last="Mengoli">Carlo Mengoli</name></noRegion><name sortKey="Cogliati, Massimo" sort="Cogliati, Massimo" uniqKey="Cogliati M" first="Massimo" last="Cogliati">Massimo Cogliati</name></country><country name="États-Unis"><noRegion><name sortKey="Caliendo, Angela M" sort="Caliendo, Angela M" uniqKey="Caliendo A" first="Angela M" last="Caliendo">Angela M. Caliendo</name></noRegion></country><country name="République tchèque"><noRegion><name sortKey="Hamal, Petr" sort="Hamal, Petr" uniqKey="Hamal P" first="Petr" last="Hamal">Petr Hamal</name></noRegion><name sortKey="Lengerova, Martina" sort="Lengerova, Martina" uniqKey="Lengerova M" first="Martina" last="Lengerova">Martina Lengerova</name></country><country name="Suisse"><noRegion><name sortKey="Jaton, Katia" sort="Jaton, Katia" uniqKey="Jaton K" first="Katia" last="Jaton">Katia Jaton</name></noRegion></country><country name="Autriche"><noRegion><name sortKey="Lass Florl, Cornelia" sort="Lass Florl, Cornelia" uniqKey="Lass Florl C" first="Cornelia" last="Lass-Florl">Cornelia Lass-Florl</name></noRegion><name sortKey="Willinger, Birgit" sort="Willinger, Birgit" uniqKey="Willinger B" first="Birgit" last="Willinger">Birgit Willinger</name></country><country name="Irlande (pays)"><noRegion><name sortKey="Talento, Alida Fe" sort="Talento, Alida Fe" uniqKey="Talento A" first="Alida Fe" last="Talento">Alida Fe Talento</name></noRegion></country><country name="Allemagne"><region name="Berlin"><name sortKey="Ruhnke, Markus" sort="Ruhnke, Markus" uniqKey="Ruhnke M" first="Markus" last="Ruhnke">Markus Ruhnke</name></region><name sortKey="Loeffler, Juergen" sort="Loeffler, Juergen" uniqKey="Loeffler J" first="Juergen" last="Loeffler">Juergen Loeffler</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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