Objectives: This prospective study was performed to evaluate the performance of galactomannan (GM) detection in the diagnosis of invasive aspergillosis (IA) in lung transplant recipients, using bronchoalveolar lavage (BAL) samples. Methods: 117 BAL samples from 60 lung transplant recipients were studied, during Mar 2007- Nov 2008. The EORTC/MSG criteria for the diagnosis of IA were modified to allow lung transplantation as a host factor. BAL samples were processed according with manufacturer’s instructions for serum samples (Platelia Aspergillus EIA, Bio-Rad). Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated in reference to proven and probable cases of IA. Reasons for performing bronchoscopy on patients were also recorded. The protocol received approval by the local ethic committee. Results: From the 117 samples studied, 5 (4.3%) were classified as proven, 6 (5.1%) as probable, and 35 (29.9%) as possible cases of aspergillosis. Twelve samples (10.3%) represented colonization, and 59 BAL samples were obtained during routine surveillance. Pulmonary aspergillosis was the main clinical presentation of IA (63.6%). Using ROC analysis, the best cut-off for galactomannan testing in BAL was defined as 1.5 (sensitivity 90.9%, specificity 90.6%, PPV 48% and NPV 99.1%). Median BAL GM index for the group of patients with proven/probable aspergillosis and for ’negative cases’ were 3.3 and 0.5, respectively (p90%.
Full conference title:
19th European Congress of Clinical Microbiology and Infectious Diseases
- ECCMID 19th (2009)