Galactomannan antigen assay from bronchoalveolar lavage fluid in diagnosis of invasive pulmonary aspergillosis in intensive care units patients

Abstract

Background:Invasive pulmonary aspergillosis (IPA) is an important infection in critically ill patients including patients of intensive care units (ICU). Different diagnostic tools are available and since its mortality is high, it is vital to start the antifungal therapy as soon as possible. Knowing the epidemiology of this disease in each ICU and area will help to better and more rapid management of such patients. The aim of this study is to determine the frequency of IPA based on the level of galactomannan in bronchoalveolar lavage fluid in ICU of Al-Zahra hospital, Isfahan, Iran.Materials and Methods:This was a cross sectional study, which was conducted in Al-Zahra hospital, Isfahan, Iran, between 2010 to 2011. The study population was all the patients admitted to ICU and were suspected to have invasive Aspergillus spp pneumonia. The level of galactomannan in bronchoalveolar lavage was measured and demographic data were gathered by the questionnaire.Results:The frequency of IPA in this study was calculated as 2.43% while galactomannan level in bronchoalveolar lavage fluid of this patient (2.50) was significantly higher than others (0.03 ± 0.02).Conclusion:Larger studies are required to determine the exact frequency of IPA and the best antifungal therapy for it.

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.

“…According to our findings, frequency of IPA was 2.43% among the studied patients, while the GM level in the BAL fluid sample of the IPA positive patient (2.50) was significantly higher compared to other subjects (0.03±0.02) [ 2 ].…”

“…Patients who met the inclusion criteria underwent fiberoptic bronchoscopy performed by a specialist, and BAL fluid samples were obtained from the subjects. Based on the instructions of the manufacturer (BIO-RAD, France), the sandwich ELISA test was used to determine the GM level in BAL samples at the Infectious Disease Research Center of Isfahan, Iran [ 2 ]. According to the results, one male patient aged 64 years was positive for IPA, with the mean GM level of 2.5.…”