The predictive value of galactomannan antigen detection in sera of patient with invasive aspergillosis

Ref ID: 19242

Author:

E. Papapetrou, C. Gartzonika, E. Priavali, D. Papamichail, E. Vediava, S. Soulti, S. Levidiotou*

Author address:

Ioannina, GR

Full conference title:

23rd European Congress of Clinical Microbiology and
Infectious Diseases

Date: 27 April 2014

Abstract:

Objectives: The diagnosis of invasive aspergillosis (IA) has been a major problem, especially in immunocompromised patients. The detection of galactomannan antigen in sera has included as a criterion (indirect tests) for probable invasive aspergillosis, according to European Organization for Research and Treatment of Cancer and Mycoses Study Group of the National Institute of Allergy and Infectious Diseases (EORT/MSG). The cause of this retrospective study is to show the predictive value of the galactomannan antigen detection in sera of immunocompromised patients with invasive aspergillosis.
Methods: From 2008 to 2012 in the University Hospital of Ioannina in Northwest Greece, we recorded 12 cases of probable IA according to EORT/MSG. For the radiological examination was used chest X-ray or CT scan. For the detection of galactomannan in sera was used Platelia Aspergillus EIA. Sera with an Index > 0,5 were considered positive for galactomannan antigen. Additionally, respiratory specimens from suspected patients were cultured in Sabouraud dextrose agar, in 370C for two weeks.
Results: In our study, we recorded 12 patients with probable IA. All the patients had positive cultures for Aspergillus fumigatus and radiological findings in chest X-ray or in CT scan. All the patients had the test for galactomannan antigen positive in two specimens. The mean value of Index in sera was 0,72 (range 0,59-1,05).The patients were 8 males (66,6%) and 4 females (33,3%). The mean age of the patients was 65 years (range 31-90 years). Six patients (50%) had solid tumors: 2 lung cancer, 2 pancreatic cancer, 1 hepatoma and 1 prostate cancer. One (8,3%) had tuberculosis, one had fibrocystic disease (8,3%) and four (33,3%) had received systemic steroids the last month before the diagnosis of IA. Six patients with solid tumors had also received cytotoxic chemotherapy the last month before the diagnosis of IA. No patient had received prior antifungal prophylaxis. The total mortality at 30 days was 25% (3 out of 12 patients).
Conclusion: Summarizing it’s important to note, that the application of the test to all patients with suspicion of invasive aspergillosis, could contribute to an early diagnosis of IA and lead to immediate treatment of the disease. Although the detection of galactomannan antigen in sera applies in patients with hematological malignancies, the experience from the use of the test in the present study shows the major predictive value to patients with solid tumors.

Abstract Number: R2861

Conference Year: 2013

Link to conference website: http://registration.akm.ch/einsicht.php?XNABSTRACT_ID=163414&XNSPRACHE_ID=2&XNKONGRESS_ID=180&XNMASK

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