Objectives: Invasive Aspergillosis is a fungal disease that can carry a high morbidity and mortality, especially in those patients who are immunosuppressed. Early diagnosis of Invasive Aspergillosis (IA) is key to implementing early treatment and improve patient prognosis. While respiratory samples may culture Aspergillus, it is essential to differentiate between active infection verses colonisation of the lung. This differentiation can often be difficult as well as time consuming. This potential for delay in treatment commencement could contribute to a poor outcome, or if treated incorrectly may expose the patient to unnecessary antifungal therapy. Therefore utilisation of a test that can reliably differentiate between colonisation and active infection would have benefits for patient care.
Aim: To evaluate the OLM™ LFD in the laboratory and implications for clinical practice. To assess the contribution this test can make to patient care
Methods: Twenty random patient samples (bronchoalveolar lavage) were used to complete this pilot study. Nine samples were Aspergillus culture positive, fifteen samples were Aspergillus culture negative and two samples NEQAS controls; Aspergillus sp. and Trichophyton sp. culture positive. The OLM™ LFD was evaluated as per the manufacturer’s guidelines, which included the pre-treatment steps as required
Results: The results obtained from the LFD analysed in conjunction with previous microbiological cultures, calcofluor/KOH results, histological specimens, radiological imaging and clinical details where applicable. LFD results demonstrated 100% sensitivity and 85% specificity as well as a positive predictive value of 71% and a negative predictive value of 100%. The LFD detected the presence of Aspergillus in three samples which was missed in the previously carried out culture and calcofluor/KOH. In this instance, Aspergillus infection was suspected from patient scans, which nicely correlated with the LFD result.
Conclusion: Based on results of this study, OLM™ LFD will be introduced in MMUH, for patients with suspected IA, or those severely immune-suppressed.
Full conference title:
- TIMM (2019)