Invasive aspergillosis (IA) is a severe, rapidly progressive, and often fatal disease in patients undergoing bone marrow transplantation (BMT). Early diagnosis, critical for rapid therapeutic intervention and improved prognosis, is difficult. Commercial latex agglutination and sandwich enzyme immunoassays have been developed to detect galactomannan, a cell wall antigen of Aspergillus spp., in serum. Sensitivites for these tests have been reported to range from 16% to 95%. Therefore, we evaluated a rapid (3 h) inhibition enzyme immunoassay (EIA) developed in our laboratory to detect galactomannanemia. Patients were followed over a 2 year period, and 176 sera were tested from 17 BMT patients with culture or histopathology-confirmed IA. Sera were collected sequentially as early as 2 months before - to as late as 1 month after confirmation of IA. The EIA was positive at some time during the disease episode for 71% (12/17) of patients. Eight of 17 patients had clinical signs before confirmed diagnosis; for 5 of these (63%), the EIA predicted IA before the onset of clinical signs. Of the 14 patients with samples available before confirmed diagnosis, the EIA was positive in 79% (11/14) before diagnosis. Among IA patients, the overall test sensitivity was 50% and test specificity was 96%. These results indicate that the EIA is useful for early diagnosis and monitoring of IA in high-risk BMT patients and could serve as an adjunct to current diagnostic methods.
Full conference title:
38th Interscience Conference on Antimicrobial Agents and Chemotherapy
- ICAAC 38th