Detection of invasive aspergillosis in immunocompromised patients with the galactomannan antigen assay

Ref ID: 19227

Author:

K.-S. Woo*, J.-L. Choi, B.-R. Kim, J.-E. Kim, K.-H. Kim, J.-M. Kim, J.-Y. Han

Author address:

Busan, KR

Full conference title:

23rd European Congress of Clinical Microbiology and
Infectious Diseases

Date: 27 April 2014

Abstract:

Background: Invasive aspergillosis (IA) is a major cause of morbidity and mortality in immunocompromised patients. Most IA occurs in hematological malignancy patients, particularly AML patients. The gold standard for IA diagnosis is tissue biopsy, but obtaining tissue specimens is often difficult. A recent IA diagnostic tool is the galactomannan (GM) assay. In this study, we analyzed patients that requested the assay and evaluated its diagnostic potential.
Methods: Patients who requested the GM assay in Dong-A University Hospital from January 1 to June 30, 2012 were retrospectively evaluated. All clinical data for diagnosing fungal infections, including microbiology cultures, cytology reports from bronchoalveolar lavage procedures, biopsy findings, and CT scans, were reviewed. We analyzed patient characteristics and calculated sensitivity, specificity, and negative and positive predictive values of the GM assay towards IA infection.
Results: Of 620 assays run, 193 were positive. Among 193 specimens from 87 patients, most had hematologic malignancy, including AML and plasma cell myeloma. After a complete retrospective review of each patient’s clinical course, 75 of the 87 patients had no clinical, radiographic, or microbiological criteria for IA. None of the remaining patients had IA proven by biopsy. However, 12 patients suspected for clinical diagnosis of IA were all GM assay-positive.
Conclusions: Our findings indicate that, in correlation with clinical and radiological criteria, GM assay screenings may assist physicians in diagnosing IA early, and represent a useful test for diagnosing IA in immunocompromised patients from whom biopsy specimens are difficult to obtain. A positive serum GM assay for diagnosis of an invasive fungal infection may be appropriate and more clinically useful. It may also allow appropriate initiation of effective treatment, which is especially important in high-risk patients.

Abstract Number: P1736

Conference Year: 2013

Link to conference website: http://registration.akm.ch/einsicht.php?XNABSTRACT_ID=163222&XNSPRACHE_ID=2&XNKONGRESS_ID=180&XNMASK

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