1,3-Beta-D-glucan for the diagnosis of invasive pulmonary aspergillosis in patients with chronic obstructive pulmonary disease

Ref ID: 19384

Author:

G. Metan, N. Tutar and A. N. Koc

Author address:

Erciyes Univesity Faculty of Medicine, Kayseri, Turkey

Full conference title:

6th Trends in Medical Mycology 2013

Date: 11 October 2014

Abstract:

Background Patients with chronic obstructive pulmonary disease is
at risk for invasive pulmonary aspergillosis (IPA) particularly under
corticosteroid therapy. Here, we evaluated the role of 1,3-beta-D-glu-
can (Fungitell, Associates of Cape Cod) detection for the diagnosis of
IPA in COPD patients with IPA.
Methods The records of mycology laboratory was searched to iden-
tify the COPD patients with Aspergillus isolation from lower respira-
tory tract (LRT) samples, retrospectively The inclusion criteria were
1- the isolation of Aspergillus from LRT culture 2- COPD diagnosis
established according to the Global Initiative for Chronic Obstructive
Lung Disease (GOLD) criteria 3- COPD patients who had a history
of steroid use in the last 3 weeks before admission 4- the isolation
is not considered as colonization 5- At least one 1,3-beta-D-glucan
(BDG) measurement from serum before antifungal therapy. Patients
were classified as having proven IPA or probable IPA on the basis
of the criteria established by the European Organization for
Research and Treatment of Cancer and Mycoses Study Group (inde-
pendent of the BDG results). Galactomannan antigenemia (GM)
(Platelia Aspergillus ELISA; Bio-Rad Laboratories) and BDG (Fungi-
tell kit; Associates of Cape Cod, East Falmouth, MA, USA) tests were
carried out in accordance with the manufacturers’ specifications.
The cut-off for BDG positivity was set at 80 pg/ml and for GM was
set at 0.5.
Results We were able to identify four COPD patients with IPA (Two
patients with proven IPA, two patients with probable IPA)) who had
a BDG measurement. Aspergillus fumigatus was isolated from the spu-
tum of two patients and transbronchial biopsy of one patient and
sputum culture yielded Aspergillus niger from one patient. While BDG
was positive in 3 out 4 patients, GM was positive in one patient
(Table 1).
Conclusions Detection of BDG in serum can be helpful for the diag-
nosis of IPA in patients with COPD. However, prospective clinical
studies are required to understand the exact role of BDG measure-
ment in this patient group.

Abstract Number: p054

Conference Year: 2013

Link to conference website: NULL

New link: NULL

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