| Aspergillus galactomannan antigen assay in bronchoalveolar lavage fluid for diagnosis of invasive pulmonary aspergillosis. | |
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MedLine Citation:
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PMID: 20833201 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: A recently developed bronchoalveolar lavage (BAL) galactomannan (GM) assay shows promising results. We evaluated the diagnostic performance of this assay and analyzed risk factors for false-positive results. METHODS: A prospective cohort study was performed in a tertiary hospital over a 9-month period. We reviewed all adult patients who underwent GM assays of BAL. Patients were categorized with proven, probable, or possible invasive pulmonary aspergillosis (IPA) according to revised EORTC/MSG definitions. Each patient with a false-positive BAL GM result was matched with three patients with true-negative BAL GM result, and the risk factors for false-positive BAL GM results were determined. RESULTS: Of 359 enrolled patients, 22 (6%) were diagnosed with IPA (1 proven, 17 probable, and 4 possible). Of the 22 patients with IPA, 17 (77%) had already received antifungal agents before the BAL GM assay was conducted. At an index cutoff value of ≥0.5, the BAL GM assay had a sensitivity of 64% (95% CI 41%-83%) and a specificity of 89% (95% CI 85%-92%). However, at an index cutoff value of ≥0.2, the BAL GM assay had a sensitivity of 86% (95% CI 65%-97%) and a specificity of 74% (95% CI 69%-79%). Of the 52 patients with positive BAL GM assay (≥0.5), 25 (7%) were false-positives. Univariate and multivariate analysis revealed that treatment with piperacillin-tazobactam or ampicillin-sulbactam was associated with false-positive BAL GM results. CONCLUSIONS: The BAL GM assay appears promising for the diagnosis of IPA. However, treatment with certain antibiotics may interfere with the results of the BAL GM assay. |
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Authors:
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Seong Yeon Park; Sang-Oh Lee; Sang-Ho Choi; Heungsup Sung; Mi-Na Kim; Chang-Min Choi; Sang-Bum Hong; Yeon-Mok Oh; Tae Sun Shim; Younsuck Koh; Yang Soo Kim; Jun Hee Woo; Sung-Han Kim |
Publication Detail:
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Type: Evaluation Studies; Journal Article Date: 2010-09-15 |
Journal Detail:
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Title: The Journal of infection Volume: 61 ISSN: 1532-2742 ISO Abbreviation: J. Infect. Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-30 Completed Date: 2011-03-02 Revised Date: 2013-01-04 |
Medline Journal Info:
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Nlm Unique ID: 7908424 Medline TA: J Infect Country: England |
Other Details:
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Languages: eng Pagination: 492-8 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 The British Infection Association. Published by Elsevier Ltd. All rights reserved. |
Affiliation:
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Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap-dong, Songpa-gu, Seoul 138-736, Republic of Korea. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Antigens, Fungal / analysis* Aspergillus / chemistry, isolation & purification* Bronchoalveolar Lavage Fluid / chemistry*, microbiology Cohort Studies False Positive Reactions Female Humans Invasive Pulmonary Aspergillosis / diagnosis* Male Mannans / analysis* Middle Aged Retrospective Studies Sensitivity and Specificity Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Antigens, Fungal; 0/Mannans; 11078-30-1/galactomannan |
| Comments/Corrections | |
Comment In:
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J Infect. 2012 Nov;65(5):470-3
[PMID:
22863901
]
J Infect. 2012 Dec;65(6):588-91 [PMID: 23078908 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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