Galactomannan determination for diagnosis of invasive aspergillosis in different groups hematooncological patients in Saint-Petersburg, Russia

Ref ID: 19419

Author:

S. Ignatyeva,1 V. A. Spiridonova,1 T. S. Bogomolova,1
O. V. Shadrivova,1 Y. V. Borzova,1 E. A. Desyatik,1
S. N. Khostelidi,1 A. G. Volkova,2 M. O. Popova,2 A. S. Kolbin,3
I. S. Zjuzgin,4 A. V. Klimovich,5 N. V. Vasilyeva,1 L. S.
Zubarovskaja,2 B.

Author address:

1I.Metchnikov North-Western State Medical University, Saint
Petersburg, Russian Federation; 2Institute of Children’s
hematology and transplantology named after R.M. Gorbach,
Saint Petersburg, Russian Federation; 3Pediatric City Hospital N1,
Saint

Full conference title:

6th Trends in Medical Mycology 2013

Date: 11 October 2014

Abstract:

Objectives To analyze the utility of galactomannan (GM) test for the
diagnosis of invasive aspergillosis (IA) in patients with hematological
malignancies in St. Petersburg, Russia.
Methods The study included 728 samples: 480 serum, 164 bronc-
hoalveolar lavage fluid (BAL) and 15 cerebrospinal fluid (CSF) from
351 hematooncological patients with IA in 19 hospitals in St. Peters-
burg in 1998-2012 yy. Diagnosis of IA was based on EORTC/MSG
2008 criteria. Detection of GM was performed with “œPlatelia Aspergillus
EIA”(Bio-Rad). The test was considered as positive with a cut-off
of 0.5 (serum, CSF) and 1.0 (BAL). BAL and CSF were examined
by direct microscopy with calcofluor white and culture.
Results Test “œPlatelia Aspergillus EIA”was positive in serum of
65,0% of patients invasive aspergillosis: in 62,8% – pulmonary asper-
gillosis, 57,7% – Aspergillus synusitis and 73% – central nervous su-
stem aspergillosis. Direct microscopic examination of BAL, sputum,
cerebrospinal fluid and discharge from sinuses was positive in 28% of
cases. Aspergillus spp. were isolated in 26% of cases. Level of GM
index in samples differed: in serum was 0,5 – 2,7, CSF – 0,5 – 2,0,
and in BAL – 1,0-7,5.
Sensitivity of GM test in BAL were higher, than in serum on
12,9% at similar specificity (83% vs. 86,0%). The positive results of
GM test in BAL samples and serum samples correlated with positive
results of microscopy and culture of BAL in 60% and 30%, respec-
tively. In hematological patients with IA a higher level GM index (2,
0-7,5) was found in the BAL samples more frequently along with a
positive microscopy than with positive mycological culture.
Conclusion This study indicates that GM test in serum, BAL and
CSF has a significant impact on the diagnostics of IA in patients with
hematologic malignancies. The sensitivity of “œPlatelia Aspergillus
EIA”test was higher than that of classical mycological methods and
depends on the type of biological specimen.

Abstract Number: p183

Conference Year: 2013

Link to conference website: NULL

New link: NULL

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