Invasive Aspergillosis in Pediatric Hematology Oncology Ward

Background: Patients with prolonged neutropenia and/or severe underlying immunosuppression are at thegreatest risk for disseminated aspergillosis. This study was undertaken to determine the incidence of invasiveaspergillosis by Platelia Aspergillus enzyme-linked immunosorbent assay ELISA kit in high risk children admitted tothe hematology ward of Dr. Faghihi hospital, Shiraz University of Medical Sciences, Iran.Materials and Methods: From Oct. 2006 to Jun. 2008, 62 patients with hematologic malignancies were followedand evaluated for invasive aspergillosis in Shiraz. All clinical samples were cultured and a direct microscopic examinationwas performed. Blood samples were cultured by bedside inoculation to BACTEC medium.Blood samples were collected prospectively once a week and stored at –20 ˚C until examination. All the collectedblood samples were assayed for galactomannan antigen using Platelia Aspergillus ELISA kit. Patients were classifiedaccording to the diagnostic criteria set by the European Organization for Research and Treatment of Cancer-MycosisStudy Group.Results: The female-to-male ratio was 22:40, and mean age of the patients was 9.3 years. The sensitivity, specificity,negative and positive predictive values of the ELISA method were 91% , 90%, 83.3%, and 94.7%, respectively. Galactomannanantigen test was positive in 1 proven, 8 probable, and 2 possible cases. The incidence rate of invasiveaspergillosis was found to be 16.7%.Conclusion: Considering the incidence of invasive aspergillosis and the corresponding morbidity and mortality ratesin patients with hematologic disorders, it seems that more efficient methods are in demand for early diagnosis andthereby promoting the patients’ survival.