Galactomannan testing of serum and  bronchoalveolar lavage fluid  for diagnosis of invasive aspergillosis in different hematooncological patients in Saint -Petersburg , Russia

Ref ID: 19576

Author:

SM Ignatyeva1*, VA Spiridonova1, OV Shadrivova1, YV Borzova1, EA Desyatik1, SN Khostelidi1,
AG Volkova2, MO Popova2, AS Kolbin3, IS Zjuzgin4, AV Klimovich5, NV Vasilyeva1,
LS Zubarovskaja2, BV Afanasyev2, NN Klimko1

Author address:

1Kashkin Research Institute of Medical Mycology, I.Metchnikov North-Western State Medical University,
Saint-Petersburg, Russia
2R. Gorbacheva Institute of Children’s Hematology and Transplantology, Saint-Petersburg, Russia
3Pediatric City Hospital

Full conference title:

6th Advances Against Aspergillosis 2014

Abstract:

Purpose:
To analyze the utility of galactomannan (GM) test for the diagnosis of invasive aspergillosis (IA) in
different groups patients with hematological malignancies in St. Petersburg, Russia.
Methods:
The study included 651 samples: 390 serum and 261 bronchoalveolar lavage fluid (BAL) from 360
hematological patients (313 specimens of neutropenic patients and 338 specimens of bone marrow
transplant recipients) with IA in Saint-Petersburg between 1998 and 2013 yy. Diagnosis of IA was
based on EORTC/MSG 2008 criteria. Detection of GM was performed with “œPlatelia Aspergillus
EIA” (Bio-Rad Laboratories). As controls, 216 samples were collected from the hematological
patients without IA. The test was considered as positive with cut-off of ≥ 0,5 (serum) and ≥ 1,0
(BAL). We calculated the sensitivity, specificity, positive predictive value and negative predictive
value for the GM assay. Two-tailed p values of “¹ 0,05 were considered statistically significant.
Results:
The patients were: adult – 84%, children – 16%. The mean age of patients was 37 years (range 1-77),
male – 54%, female – 46%. Sensitivity of GM test in adult neutropenic patients and in bone marrow
transplant recipients was identical (72% vs.73%). Positive results of GM test in BAL specimens of
neutropenic children with IA was revealed more often, than at bone marrow transplant recipients
group (91% vs. 63%, P=0,002). In neutropenic patients with IA a higher level GM index (2, 0 – 7, 5)
was found in the BAL samples more frequently in children, than in adult (60% vs. 23%, P=0,012)
and was similar in different groups bone marrow transplant recipients. The prognostic value of
positive and negative result of the GM test in serum samples of neutropenic patients and bone
marrow transplant recipients were 0,77 (95%CI 0,71-0,87) and 0,86 (95%CI 0,83-0,88), in BAL
samples – 0,85 (95%CI 0,79-0,94) and 0,84 (95%CI 0,78-0,96), respectively.
Conclusion:
This study indicates that sensitivity, prognostic value of positive and negative result of GM test in
neutropenic patients and in bone marrow transplant recipients depends on the type of biological
specimen and varies for adult and children.

Abstract Number: 102

Conference Year: 2014

Link to conference website: http://www.AAA2014.org

New link: NULL

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