detection of galactomannan in bronchoalveolar lavage of the intensive care unit patients at risk for invasive aspergillosis
نویسندگان
چکیده
background and purpose: invasive aspergillosis (ia) is one of the most common life-threatening fungal infections among the critically ill patients including intensive care unit (icu) patients. delayed diagnosis and therapy may lead to poor outcomes. diagnosis may be facilitated by a test for molecular biomarkers, i.e. detection of galactomannan (gm) antigen based on enzyme immunoassay, which is of increasing interest in the clinical settings for the diagnosis of ia. in the present study, we assessed gm testing of bronchoalveolar lavage (bal) fluid as a tool for early diagnosis of ia among icu patients who were at risk for developing ia. material and methods: a prospective study was performed in icu patients with underlying predisposing conditions for ia between august 2010 and september 2011. bal samples for direct microscopic examination, culture, and gm detection were obtained once or twice weekly. gm in bal levels was measured using the platellia aspergillus eia test kit. according to modified european organization for the research and treatment of cancer/ mycoses study group (eortc/msg) criteria, patients were classified as having probable or possible ia. results: out of 43 suspected patients to ia, 13 (30.2%) cases showed ia. according to the criteria presented by eortc/msg, they were categorized as: 4 cases (30.8%) of possible ia and 9 (69.2%) of probable ia. out of 21 bal samples from patients with ia, 11 (52.4%) had at least one positive bal gm index. using a cutoff index of 0.5, the sensitivity and specificity, positive and negative predictive values of gm detection in bal fluid were 100%, 85.7%, 65.7% and 96%, respectively. the sensitivity and specificity was 73% and 92.7% at cutoff ≥1.0, respectively. in 6 of 13 ia cases, bal culture or direct microscopic examination remained negative, whereas gm in bal was positive. conclusion: our data have revealed that the sensitivity of gm detection in bal was better than that of conventional tests. it seems that gm detection in bal is beneficial to establish or exclude the early diagnosis of ia in icu patients.
منابع مشابه
Detection of galactomannan in bronchoalveolar lavage of the intensive care unit patients at risk for invasive aspergillosis
Background and Purpose: Invasive aspergillosis (IA) is one of the most common life-threatening fungal infections among the critically ill patients including intensive care unit (ICU) patients. Delayed diagnosis and therapy may lead to poor outcomes. Diagnosis may be facilitated by a test for molecular biomarkers, i.e. detection of galactomannan (GM) antigen based on enzyme immunoassay, which is...
متن کاملComments on \'\'Detection of galactomannan in the bronchoalveolar lavage of high-risk patients with invasive aspergillosis admitted at the intensive care unit\'\' by Khodavaisy et al.
Comments on ''Detection of galactomannan in the bronchoalveolar lavage of high-risk patients with invasive aspergillosis admitted at the intensive care unit'' by Khodavaisy et al. AWT-SEP AWT-SEP AWT-SEP AWT-SEP AWT-SEP AWT-SEP Galactomannan in bronchoalveolar lavage for diagnosis of invasive aspergillosis We rea...
متن کاملDetection of galactomannan in bronchoalveolar lavage of the intensive care unit patients at risk for invasive aspergillosis
BACKGROUND AND PURPOSE Invasive aspergillosis (IA) is one of the most common life-threatening fungal infections among the critically ill patients including intensive care unit (ICU) patients. Delayed diagnosis and therapy may lead to poor outcomes. Diagnosis may be facilitated by a test for molecular biomarkers, i.e. detection of galactomannan (GM) antigen based on enzyme immunoassay, which is ...
متن کاملGalactomannan in bronchoalveolar lavage fluid: a tool for diagnosing aspergillosis in intensive care unit patients.
RATIONALE Invasive aspergillosis (IA) is an important cause of mortality in patients with hematologic malignancies. However, IA appears to be gaining a foothold in the intensive care unit (ICU) in patients without classical risk factors. A recent study described 89 cases of IA in patients in a medical ICU without leukemia or cancer. The diagnosis of IA remains difficult and is often established...
متن کاملComments on ''Detection of galactomannan in the bronchoalveolar lavage of high-risk patients with invasive aspergillosis admitted at the intensive care unit'' by Khodavaisy et al.
1 Copyright© 2015, Published by Mazandaran University of Medical Sciences on behalf of Iranian Society of Medical Mycology and Invasive Fungi Research Center. This is an openaccess article distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just ...
متن کاملDetection of galactomannan in bronchoalveolar lavage fluid samples of patients at risk for invasive pulmonary aspergillosis: analytical and clinical validity.
Invasive pulmonary aspergillosis (IPA) is frequent and often fatal in immunosuppressed patients. Timely diagnosis of IPA improves survival but is difficult to make. We examined the analytical and clinical validity of galactomannan (GM) testing of bronchoalveolar lavage (BAL) fluid in diagnosing IPA in a mixed population by retrospectively reviewing records of 251 consecutive at-risk patients fo...
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عنوان ژورنال:
current medical mycologyجلد ۱، شماره ۱، صفحات ۱۲-۱۷
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