| Bronchoalveolar lavage fluid galactomannan for the diagnosis of invasive pulmonary aspergillosis in patients with hematologic diseases. | |
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MedLine Citation:
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PMID: 19886801 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Prompt diagnosis of invasive pulmonary aspergillosis (IPA) remains a challenge. Galactomannan (GM) detection in bronchoalveolar lavage (BAL) fluid by the Platelia enzyme immunoassay aims to further improve upon the test's utility by applying it directly to specimens from the target organ. METHODS: A retrospective analysis of the Platelia assay was performed on BAL samples from 99 evaluable high-risk hematology patients, including 58 with proven or probable IPA. RESULTS: BAL GM demonstrated an improved sensitivity profile (91.3% with an optical density [OD] index cutoff of >or=1.0) in comparison with culture and microscopy (50% and 53.3%, respectively). The diagnostic accuracy as given by the area under the receiver operating characteristic curve was 0.93 (95% confidence interval, 0.88-0.99); further decreasing the OD index cutoff to 0.5 compromised specificity more than it improved sensitivity. Estimates of the positive and negative predictive value of the Platelia assay on BAL samples (OD index, >or=1.0) were 76% and 96%, respectively. The mean BAL GM OD index was not different in neutropenic versus nonneutropenic case patients (3.9 and 4.5, respectively; P = .3); however, a trend toward decreased sensitivity in patients receiving mold-active prophylaxis was noted. CONCLUSION: BAL GM is a valuable adjunctive diagnostic tool to other conventional microbiologic and radiologic studies. |
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Authors:
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Johan Maertens; Vincent Maertens; Koen Theunissen; Wouter Meersseman; Philippe Meersseman; Stef Meers; Eric Verbeken; Gregor Verhoef; Johan Van Eldere; Katrien Lagrou |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America Volume: 49 ISSN: 1537-6591 ISO Abbreviation: Clin. Infect. Dis. Publication Date: 2009 Dec |
Date Detail:
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Created Date: 2009-11-10 Completed Date: 2010-01-26 Revised Date: 2010-03-16 |
Medline Journal Info:
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Nlm Unique ID: 9203213 Medline TA: Clin Infect Dis Country: United States |
Other Details:
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Languages: eng Pagination: 1688-93 Citation Subset: IM |
Affiliation:
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Department of Hematology, Medical Intensive Care Unit, University Hospital Gasthuisberg, Leuven, Belgium |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Bronchoalveolar Lavage Fluid
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chemistry* Case-Control Studies Hematologic Diseases / complications*, microbiology* Humans Invasive Pulmonary Aspergillosis / diagnosis* Mannans / analysis*, chemistry Middle Aged Retrospective Studies Sensitivity and Specificity |
| Chemical | |
Reg. No./Substance:
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0/Mannans; 11078-30-1/galactomannan |
| Comments/Corrections | |
Comment In:
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Clin Infect Dis. 2010 Apr 1;50(7):1070; author reply 1071-2
[PMID:
20201671
]
Clin Infect Dis. 2010 Apr 1;50(7):1070-1; author reply 1071-2 [PMID: 20201672 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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