Bronchoalveolar lavage lateral-flow device test for diagnosing invasive pulmonary aspergillosis: a multicenter study

Ref ID: 19382

Author:

M. Hoenigl,1 W. Duettmann,1 C. Koidl,1 B. Waitzl,1 B. Sartori,2
K. Seeber,1 M. Lackner,2 V. Posch,1 W. Buzina,1 A. W€olfler,1
R. Krause,1 C. Thornton3 and C. Lass-Florl2

Author address:

1Medical University of Graz, Austria; 2Innsbruck Med. University,
Austria and 3Univ. of Exeter, United Kingdom

Full conference title:

6th Trends in Medical Mycology 2013

Date: 11 October 2014

Abstract:

Background Timely diagnosis is a key factor in successful treatment
of invasive pulmonary aspergillosis (IPA). Limitations of galactoman-
nan (GM) testing are varying turnaround time and availability.
These limitations may be overcome by the Lateral- Flow Device (LFD)
test, a single sample point-of-care test that is based on the detection
of an Aspergillus extracellular glycoprotein antigen by monoclonal
antibody JF5. This study evaluates the LFD test by using bronchoal-
veolar lavage (BAL) samples.
Methods A total of 173 BAL samples from 167 patients that were
tested routinely for GM between between 2011 and 2013 at the
Austrian University Hospitals of Graz (98 samples) and Innsbruck
(75 samples) were included. 53 had probable/proven, 52 possible,
and 68 no IPA. Diagnostic accuracy of LFD for probable/proven IPA
was evaluated. For IPA grading fungal cultures as well as BAL GM
(cut-off 1.0) were used.
Results Sensitivity and specificity of LFD test for probable/proven
IPA were 75.5% and 84.2%, respectively (Graz: 95% and 84%;
Innsbruck: 63% and 84%). PPV was 68%, NPV 89%. BAL GM lev-
els were available in 108 samples (98 from Graz, 10 from Inns-
bruck) and significantly lower in patients with negative than in
those with positive LFD result (P < 0.0001). LFD resulted negative in 13 patients with probable IPA. BAL GM was tested in two of those only and revealed levels of 1.23 and 1.35. LFD resulted posi- tive in a total of 15 patients with possible and 4 without IPA (weakly to moderately positive LFD result in 17/19 cases). In 7 of these cases corresponding GM values were between 0.6 and 0.7.LFD resulted negative in proven/probable cases of infection due to Mucorales, Scedosporium spp., Fusarium spp., and Cryptococcus neoformans. Conclusions The LFD test of BAL specimens is performed easily and provides accurate and rapidly available results. Therefore, this new point-of-care test may be a very promising diagnostic approach for detecting IPA in BAL specimens.

Abstract Number: p044

Conference Year: 2013

Link to conference website: NULL

New link: NULL

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