detection of galactomannan in bronchoalveolar lavage of the intensive care unit patients at risk for invasive aspergillosis

نویسندگان

sadegh khodavaysi department of medical mycology and parasitology, kurdistan university of medical sciences, sanandaj, iran

mohmmad taghi hedayati department of medical mycology and parasitology, mazandaran university of medical sciences, sari, iran

masoud alialy department of pulmonary and critical care division, mazandaran university of medical sciences, sari, iran

mohammad reza habibi department of anesthesiologist and critical care division, mazandaran university of medical sciences, sari, iran

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.

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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...

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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.

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Detection of galactomannan in bronchoalveolar lavage of the intensive care unit patients at risk for invasive aspergillosis

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Galactomannan in bronchoalveolar lavage fluid: a tool for diagnosing aspergillosis in intensive care unit patients.

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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.

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عنوان ژورنال:
current medical mycology

جلد ۱، شماره ۱، صفحات ۱۲-۱۷

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