Invasive aspergillosis is a serious problem for immunocompromised patients, especially neutropenic. The diagnosis of this infection is complicated, since clinical symptoms are often similar to those of other fungal diseases. The chance of detecting the presence of a specific antigen in the serum could confirm the clinical suspect and, perhaps, be useful for the follow-up of the patient. The Medical Mycology Committee of AMCII decided to evaluate in a multicenter prospective study (from November 1, 1998 to February 28, 1999) the performance of the Plateliam Aspergillus kit (Bio-Rad) for the detection of Aspergillus galactomannan in human serum. The enrolled patients included various groups of immunosuppressed patients (mostly neutropenic) and blood samples were drawn at the enrollment, which was decided upon a clinical suspect (antibiotic non-responsive fever for at least 96 hours, cough, hemophtoe, positive chest X-ray), and then on day 3, 6, 9, 12, 15 and 21. Culture and histopathologic examination were performed according to the single Laboratory workflow. For each patient the Laboratory filled in a form with all the clinical information, to have a database to evaluate the results of the test. During the study, 187 patients with various kind of immunosuppression were enrolled. A total 256 sera were tested: for 117 patients (62.6%) only the basal sample was tested, whereas for the 70 symptomatic patients (37.4%) multiple specimens (range: l-6) were tested. The results allowed the Laboratories to exclude (68.6%) or confirm (25.7%: colonization, confirmed and/or probable) the clinical suspect of invasive aspergillosis; 4 cases remained undetermined. Based on this study, it seems that the use of this test should be limited to those patients with clinical symptoms of aspergillosis.
Full conference title:
Focus on Fungal Infections 11, March 14-16 2001
- Focus on Fungal Infection 11 (2001)