Bronchoalveolar Lavage Fluid Galactomannan for the Diagnosis of Invasive Pulmonary Aspergillosis in Patients with Hematologic Diseases

Maertens, Johan; Maertens, Vincent; Theunissen, Koen; Meersseman, Wouter; Meersseman, Philippe; Meers, Stef; Verbeken, Eric; Verhoef, Gregor; Eldere, Johan Van; Lagrou, Katrien

doi:10.1086/647935

Cited by 222 publications

(182 citation statements)

References 32 publications

Supporting

Mentioning

156

Contrasting

Unclassified

Order By: Relevance

“…This results show that the detection of GM in BAL fluid enhances the identification of Aspergillus species as a cause of pulmonary disease in ICU patients. The result of several studies have also shown that the GM analysis of BAL samples should consider for IA diagnosis among high-risk patients, especially for the ease of processing and the more rapid result than traditional methods (1,23,29). Moreover, all patients with probable IA had at least one positive BAL GM index, in the present study.…”

Section: Discussionsupporting

confidence: 70%

Invasive Aspergillosis in Intensive Care Unit Patients in Iran

Hedayati

Khodavaisy

Amini

et al. 2013

Acta Med. (Hradec Kralove, Czech Repub.)

View full text Add to dashboard Cite

Summary:We assessed the intensive care unit (ICU) patients for Invasive aspergillosis (IA) with culture and non-culture based diagnostic methods from Iran. Thirty-six ICU patients with underlying predisposing conditions for IA were enrolled in the study. Sixty eight Bronchoalveolar lavage (BAL) samples were collected by bronchoscope twice a weekly. BAL samples were analyzed by microscopic examination, fungal culture and galactomannan (GM) detection. The Platelia Aspergillus GM EIA was used to quantify GM indices. Samples with a BAL GM index ≥1 were considered as positive for GM. Patients were classified as having probable or possible IA. Out of 36 suspected patients to IA, 36.1% of cases showed IA which were categorized as: 4 cases of possible IA and 9 of probable IA. 76.2% of BAL samples were positive for GM. From 13 patients with IA, 11 (84.6%) had at least one positive BAL GM index. Of these patients, 9 (81.8%) showed probable IA. The main underlying predisposing conditions were neutropenia (53.8%) and COPD (30.8%). Our study has indicated that COPD must be considered as one of the main predisposing condition for occurrence of aspergillosis in ICU patients. Our data have also revealed that GM detection in BAL samples play a significant role to IA diagnosis.

show abstract

Section: Discussionsupporting

confidence: 70%

Invasive Aspergillosis in Intensive Care Unit Patients in Iran

Hedayati

Khodavaisy

Amini

et al. 2013

Acta Med. (Hradec Kralove, Czech Repub.)

View full text Add to dashboard Cite

show abstract

“…25,30 The significance of biomarker testing is further outlined by the fact that positive growth of Aspergillus spp. in conventional culture is hardly achieved, as also shown in this study.…”

Section: Discussionmentioning

confidence: 99%

Galactomannan testing andAspergillusPCR in same-day bronchoalveolar lavage and blood samples for diagnosis of invasive aspergillosis

et al. 2016

View full text Add to dashboard Cite

In recent years galactomannan antigen testing (GM) and also Aspergillus PCR have become increasingly important for diagnosis of invasive aspergillosis (IA). Whether or not these tests need to be performed with bronchoalveolar lavage fluid (BALF; i.e., primary site of infection), or testing of blood samples is sufficient, remains, however, a matter of debate. We evaluated the diagnostic performance of GM ELISA, and Aspergillus PCR by using BALF samples and blood samples obtained at the same day from a total of 53 immunocompromised patients (16 with probable/proven IA and 37 with no evidence of IA according to the revised EORTC/MSG criteria; 38 patients with hematological malignancies were prospectively enrolled at the Medical University of Graz, Austria, 15 patients with mixed underlying diseases at the Mannheim University Hospital). Patients with possible IA were excluded from this analysis. A total of 34/53 (64%) of all patients and 12/16 (75%) of patients with probable/proven IA received mold-active antifungal prophylaxis/therapy at the time of the BALF procedure. Sensitivities of GM and Aspergillus PCR were 38% and 44% in BALF, and 31% and 0% in blood, respectively. Best sensitivity (75%) for detecting proven/probable IA was achieved when BALF Aspergillus PCR, BALF Eigl et al. 529GM (>1.0 ODI), BALF-culture and serum-GM (>0.5 ODI) were combined (specificity 95%).In conclusion, sensitivities of the evaluated diagnostic tests-when interpreted on their own-were low in BALF and even lower in blood, sensitivities increased markedly when diagnostic tests were combined.

show abstract

“…9,15 Pending a recommended cutoff by the manufacturer, a cutoff of 1 is used for these specimens. Although GM can also be detected in pleural fluid, sputum or urine, the experience with GM detection in these specimens is insufficient to formulate specific recommendations.…”

Section: Galactomannan (Gm)mentioning

confidence: 99%

ECIL recommendations for the use of biological markers for the diagnosis of invasive fungal diseases in leukemic patients and hematopoietic SCT recipients

Marchetti

Lamoth

Mikulska

et al. 2011

Bone Marrow Transplant

237

173

View full text Add to dashboard Cite

Bronchoalveolar Lavage Fluid Galactomannan for the Diagnosis of Invasive Pulmonary Aspergillosis in Patients with Hematologic Diseases

Abstract: BAL GM is a valuable adjunctive diagnostic tool to other conventional microbiologic and radiologic studies.

Cited by 222 publications

References 32 publications

Invasive Aspergillosis in Intensive Care Unit Patients in Iran

Invasive Aspergillosis in Intensive Care Unit Patients in Iran

Galactomannan testing andAspergillusPCR in same-day bronchoalveolar lavage and blood samples for diagnosis of invasive aspergillosis

ECIL recommendations for the use of biological markers for the diagnosis of invasive fungal diseases in leukemic patients and hematopoietic SCT recipients

Contact Info

Product

Resources

About