Serum and urine galactomannan testing for screening in patients with hematological malignancies

Ref ID: 19392

Author:

M. Hoenigl, C. Koidl, W. Duettmann, B. Huber-Krassnitzer,
B. Waitzl, P. Neumeister, V. Posch, K. Seeber, J. Wagner, H. Sill,
A. W€olfler and R. Krause

Author address:

Medical University of Graz, Austria

Full conference title:

6th Trends in Medical Mycology 2013

Date: 11 October 2014

Abstract:

Background Serum galactomannan (GM) has been established as
an important method for diagnosing invasive aspergillosis (IA). In
this study we evaluated performance of GM test in urine specimens
and compared results with those obtained in serum.
Methods The study was performed from July 2012-March 2013 in
adult patients with underlying hematological malignancies hospital-
ized at the Department of Haematology at the Medical University of
Graz in Austria and was approved by the local ethics committee.
Serum and urine samples were collected and tested twice weekly
(always on the same day). For serum samples an optical density
index (ODI) 0.5 was considered positive.
Results Each 242 serum and urine samples were collected in 75
patients (33 of those had undergone recent allogeneic stem cell trans-
plantation). 21/242 (8,7%) serum samples from 13 patients resulted
GM positive. Sensitivity, specificity, PPV and NPV for different cut-offs
for urine samples (compared to serum results) were as follows: 0.15
ODI: 33,3%, 90,5%, 25%, 93,5%; 0.1 ODI: 47,6%, 86%, 24,4%,
94,5%. A cutoff of 0.1 ODI was chosen for urine samples. 11/21 posi-
tive serum GM samples gave negative results in urine; 4 of those were
derived from a patient with increasing positive serum GM levels in
whom urine samples became positive with a 2 week delay. In 2 proba-
ble IA cases initially positive urine samples became negative under
appropriate antifungal therapy while decreasing serum samples
remained positive. 3 serum samples were considered false positives, 2
urine sample false negatives. Urine resulted positive in 31/221 nega-
tive serum GM samples. 26 of those were considered false positives.
Spearman-Rho correlation analysis revealed a significant positive cor-
relation between serum and urine samples (p < 0.001; q = 0.252). Conclusions A significant positive correlation was found between urine and serum GM results. Further studies are needed to evaluate the potential role of urine GM testing in IA diagnosis

Abstract Number: p076

Conference Year: 2013

Link to conference website: NULL

New link: NULL

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