The effect of involved Aspergillus species on galactomannan in bronchoalveolar lavage of patients with invasive aspergillosis

Mojtaba Taghizadeh-Armaki , Mohammad Taghi Hedayati , Vahid Moqarabzadeh, Saham Ansari, Saeed Mahdavi Omran, Hossein Zarrinfar, Sasan Saber, Paul E. Verweij, David Denning, Seyedmojtaba Seyedmousavi

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Abstract

The detection of galactomannan (GM) in bronchoalveolar lavage (BAL) is an important surrogate marker for the early diagnosis and therapeutic monitoring of invasive aspergillosis (IA), regardless of the involved species of Aspergillus. Therefore, we compared the Platelia Aspergillus GM EIA (Bio-Rad) for determination of GM index in BAL of patients with proven, probable or putative IA due to Aspergillus flavus versus A. fumigatus. In a prospective study between 2009 and 2015, 116 BAL samples were collected from suspected patients to IA referred to two university hospitals in Tehran, Iran. According to EORTC/MSG and Blot criteria, 35 patients were classified as IA patients, of which 33 cases had positive GM above 0.5 while among of these patients, 22 had GM index ≥ 1. Twenty eight were culture positive for A. flavus and seven for A. fumigatus. The GM index for A. flavus cases was between 0.5-6.5 and those of A. fumigatus ranged from 1 to 6.5. The sensitivity and specificity of GM index ≥ 0.5 in cases with A. flavus were 89.3% and 100% and those of A. fumigatus were 100% and 100%, respectively. The mean of GM index in IA patients with A. fumigatus (3.1) was significantly higher than those of A. flavus (1.6), (P = 0.031). In the patient group selected for a high likelihood of IA, the sensitivity of GM was lower for A. flavus compared to A. fumigatus. This finding might have implications for diagnosis in hospitals and countries with a high proportion of A. flavus infections.
Original languageEnglish
JournalJournal of medical microbiology
Early online date10 Jul 2017
DOIs
Publication statusPublished - 2017

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