Clinical utility and prognostic value of galactomannan in neutropenic patients with invasive aspergillosis

Ref ID: 19229

Author:

F. Cheikhrouhou, I. Hadrich, S. Neji, H. Trabelsi, H. Sellami, A. Znazen*, F. Makni, A. Ayadi

Author address:

Sfax, TN

Full conference title:

23rd European Congress of Clinical Microbiology and
Infectious Diseases

Date: 27 April 2014

Abstract:

Invasive aspergillosis (IA) is a major cause of morbidity and mortality in profoundly neutropenic patients. Delayed diagnosis and therapy may lead to poor outcomes.
Aims: The objective of this study was to assess the performance characteristics of the galactomannan (GM) assay in serum and broncho-alveolar lavage specimen for the diagnosis of IA in neutropenic patients with heamatological malignancies. We also evaluated the prognosis outcome.
Patients and Methods: A total of 1198 serum samples and 42 BAL from 235 neutropenic patients were tested with a GM ELISA platelia test. We used Cox modeling of time to 6 and 12-week mortality for the GM level at the time of diagnosis (GM0) and GM decay in the week following diagnosis in proven and probable IA patients with >2 GM values.
Results: There were 3 proven, 55 probable, and 4 possible cases of IA. The sensitivity and the specificity of GM test were 96.8% and 82.4% respectively. In BAL samples, sensitivity was 86% and the specificity was 93%. BAL GM was more sensitive than microscopy (22.2%) and BAL culture (38.9%). Among the patients with proven/probable IA, serum and BAL GM were in agreement for 92.8% of paired samples. The hazard ratio (HR) of GM0 and 1-week GM decay per unit increase in EIA was 1.044 (95% CI, 0.738 to 1.476) and 0.709 (95% CI, 0.236 to 2.130) respectively.
Conclusion: We conclude to good correlation between GM0 and GM decay combination and outcome of IA patients. The GM is a useful tool for the diagnosis and monitoring of the course of IA.

Abstract Number: P1735

Conference Year: 2013

Link to conference website: http://registration.akm.ch/einsicht.php?XNABSTRACT_ID=164479&XNSPRACHE_ID=2&XNKONGRESS_ID=180&XNMASK

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