Is the determination of galactomannan in non-haematological patients helpful for the diagnosis of invasive aspergillosis? The value of determination in serum of patients with clinical isolation of aspergillus
Abstract number: 1733_481
Guinea J., Jensen J., Rivera M., Alonso R., Peláez T., Muñoz P., Torres-Narbona M., Bouza E.
Objectives: Haematological patients have traditionally been the highest risk population for developing invasive aspergillosis (IA) and the detection of galactomannan (GM) in serum in these patients has been widely evaluated. However, the value of the test in non-haematological patients has received little attention. We studied the value of detecting GM in the serum of non-haematological patients with isolation of Aspergillus in clinical samples for the diagnosis of IA.
Methods: We followed up those patients admitted to non-haematological wards with one or more clinical isolations of Aspergillus in our institution from March 2003 to August 2006. The patients were classified according to EORTC standards (Ascioglu, CID 2002). A serum sample for GM detection was requested under non-surveillance conditions in those patients with a positive culture for Aspergillus. GM was detected by the Platelia Aspergillus test (Bio-Rad). A detection of GM ≥1 ng/mL was considered positive.
Results: During the study period, 75 different patients had an isolate of Aspergillus and a serum sample processed for GM detection. Admitted patients were located as follows: intensive care units 28 (37.3%), medical wards 38 (50.7%), and surgical wards 9 (12%). Of the 75 patients studied, 11 (14.7%) had proven or probable invasive aspergillosis. The underlying conditions of the patients were COPD 5 (50%), HIV infection 1 (10%), lymphoma 1 (10%), liver transplant 1 (10%), solid malignancies 1 (10%) and corticosteroid treatment 1 (10%). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the detection of GM in serum for the diagnosis of IA were 50%, 98.5%, 83.3% and 92.7%, respectively (P < 0.001).
Conclusions: The detection of GM in the sera of non-haematological patients with a clinical isolate of Aspergillus is useful for the diagnosis of IA with PPV and NPV above 83% and 92%, respectively. Jesús Guinea Pharm D, PhD, is contracted by the Fondo de Investigación Sanitaria (FIS), contract number CM05/00171.
|Session name:||European Society of Clinical Microbiology and Infectious Diseases|
|Location:||ICC, Munich, Germany|
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