Background Invasive aspergillosis is a severe infection occuring in oncohematologic patients. Galactomannan antigenemia assay with ELISA has been shown to have a high sensivity and specificity for the diagnosis of invasive aspergillosis in adult hematologic patients. The aim of the study was to evaluate the test in oncopediatric patients. Material and Methods Thirty-six patients, 7.1 y. old (range : 1-24 y.), treated by high dose chemotherapy with autologous stem cells rescue for treatment of solid tumor were included in the study. Sera were obtained weekly until discharge and tested with Platelia Aspergillus (BioRad laboratories). One hundred and seventy two sera were collected during 48 treatment episodes. Results In 12 of 48 (25 %) episodes i.e 10 of 36 (27.8%) children, at least 2 consecutive samples were positive (OD index 1.5). Using EORTC/MSG criteria, 0, 1 and 2 cases of proven, probable and possible Invasive Aspergillosis cases were identified. False-positive results were obtained for 9 of 33 (27,3%) patients. Sensibility, specificity, positive and negative predictive values of the test were of 100%, 72.7%, 10% and 100% respectively. Univariate (RR=7.5, CI95%=1.8 -32.1, p= 0.007) and multivariate (RR=7.9, CI95%=1.6 -38.3, p=0.01) analysis of risk factors showed that parenteral nutrition receipt was the only characteristic significantly associated with increase of ELISA index in patients. Neither antimicrobial treatment nor mucositis were risk factors. ELISA testing did not allow to detect any significant level of galactomannan antigen in parenteral nutrition components.
Full conference title:
The 15 th Congress of the International Society for Human and Animal Mycology
- ISHAM 15th (2003)