Serum galactomannan antigen as a prognostic and diagnostic marker for invasive aspergillosis in heterogeneous medicine ICU patient population

Dabas, Y. P. S.; Xess, Immaculata

doi:10.1371/journal.pone.0196196

Cited by 14 publications

(8 citation statements)

References 33 publications

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“…Most evidence on the utility of serum and bronchoalveolar lavage fluid (BALF)-GM estimation comes from subjects with invasive pulmonary aspergillosis (IPA) (1,(10)(11)(12). There are limited data from retrospective studies regarding the utility of serum or BALF-GM in diagnosing CPA (13)(14)(15).…”

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confidence: 99%

Utility of Serum and Bronchoalveolar Lavage Fluid Galactomannan in Diagnosis of Chronic Pulmonary Aspergillosis

et al. 2019

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The value of serum and bronchoalveolar lavage fluid galactomannan (BALF-GM) in diagnosing chronic pulmonary aspergillosis (CPA) remains unclear. Here, we study the diagnostic efficacy of GM in the diagnosis of CPA. We included consecutive treatment-naive subjects with CPA. For calculating the specificity of serum GM, we enrolled diseased controls (minimally symptomatic subjects previously treated for pulmonary tuberculosis, not meeting the criteria for CPA). To calculate the specificity of BALF-GM, subjects with pulmonary disorders other than CPA who underwent bronchoscopy were included. We determined the cutoff of serum and BALF-GM levels using receiver operating characteristic (ROC) curve analysis. We enrolled 243 consecutive treatment-naive subjects (53.5% males) of CPA with a mean (standard deviation) age of 43.6 (14.7) years. Forty-five (60% males; age, 46.7 [15.7] years) and 27 (59.3% males; age, 52.6 [12.8] years) subjects served as controls for serum and BALF-GM, respectively. The best cutoff value for serum and BALF-GM was 0.55 (area under the ROC curve [AUROC], 0.605; sensitivity, 38%; specificity, 87%) and 1.375 (AUROC, 0.836; sensitivity, 68%; specificity, 93%), respectively. At a cutoff value of 2.5, BALF-GM had a sensitivity and specificity of 50% and 100%, respectively. BALF-GM performs better than serum GM and may be helpful in the diagnosis of CPA in selected patients. More studies are required to confirm our findings.

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Utility of Serum and Bronchoalveolar Lavage Fluid Galactomannan in Diagnosis of Chronic Pulmonary Aspergillosis

et al. 2019

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“…В нашем исследовании 44% больных с РЗ находились в ОРИТ в период лечения ИА. При этом пациенты с РЗ зачастую не имеют классических факторов риска, что наряду с отсутствием характерных клинических симптомов затрудняет раннюю диагностику ИА и увеличивает показатели летальности [1,6].…”

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“…Диагностика ИА у пациентов с РЗ является сложной задачей, поскольку отсутствуют специфические клинические и рентгенологические признаки грибковой инфекции. Кроме того, микробиологические тесты, такие как микроскопия и посев респираторных биосубстратов на микромицеты, обладают низкой чувствительностью, а клиническое применение теста на галактоманнан в сыворотке крови у пациентов без нейтропении не имеет достаточного обоснования, его оптимальный порог для таких больных не установлен [6,15]. Эффективным методом серологической диагностики является определение галактоманнана в промывных водах БАЛ, при этом прогностическая ценность отрицательного результата значительно выше таковой сывороточного теста.…”

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Invasive aspergillosis in adult patients with rheumatic diseases

Мазуров

Лила

Шадривова

et al. 2020

Sovremennaâ revmatologiâ

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Objective: to study risk factors for invasive aspergillosis (IA), its etiology, clinical manifestations, and treatment efficiency in patients with rheumatic diseases (RD).Patients and methods. The first study of proven and probable IA (EORT/MSGERC, 2019) was conducted in 18 patients with RD, who accounted for 3% of all adult IA patients (n=699) included in the 1998–2020 registry of the Department of Clinical Mycology, Allergology, and Immunology, I.I. Mechnikov North-Western State Medical University (Group 1). This group comprised 56% women; the median age was 59 [21; 75] years. Group 2 (a comparison group) included 610 adult hematology patients with IA (median age, 45 [18; 79] years; 42% women). A prospective case-control study was conducted to identify risk factors for IA in patients with RD: 36 rheumatic patients without IA (median age, 58 (18–79) years; 61% women) (a control group).Results and discussion. Patients with RD were found to often develop IA in the presence of anti-neutrophilic cytoplasmic antibody-associated vasculitis (granulomatosis with polyangiitis and microscopic polyangiitis) and systemic lupus erythematosus (50 and 16%, respectively). It was shown for the first time that the likelihood of IA in patients with RD increases with prolonged (median 14 days) lymphocytopenia during RD treatment (odds ratio 13.0; 95% confidence interval, 3.3–50.3). The main causative agents of IA were A. fumigatus (50%) and A. niger (29%). IA was more severe in Group 1 than in Group 2: in the resuscitation and intensive care units, there were 44 and 18%, respectively (p=0.01). Group 1 versus Group 2 more frequently had respiratory failure (61 and 37%, respectively; p=0.03), hemoptysis (28 and 7%; p=0.0001), chest pain (17 and 7%; p=0.04), and cardiac involvement (11 and 1%; p=0.0001), and less frequently had fever (67 and 85%; p=0.01). The common site of IA was the lung (83%); the characteristic feature detected by computed tomography (CT) is pulmonary cavitation (44%). Antifungal therapy was used in 89% of Group 1 patients; the overall 12-week survival was 69%.Conclusion. In patients with RD, it is difficult to differentiate between the progression of the underlying disease, adverse drug reactions, infectious complications, or a combination of these disorders due to the similarity of their clinical manifestations. When RD patients with infectious syndrome and respiratory failure develop prolonged lymphocytopenia during combination therapy, AI should be suspected and lung CT, bronchoscopy, and mycological examination of the material obtained by bronchoalveolar lavage be done.

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“…This antigen may be detected in both serum and bronchoalveolar lavage fluid before other diagnostic tests reveal the presence of such type of fungi. Galactomannan antigen levels may be useful in the assessment of therapeutic response Question 4Answer: D Both aspergilloma (a fungal ball that usually grows in pre‐existing lung cavities), invasive bronchopulmonary aspergillosis (a potentially lethal infection where the hyphae invade through the bronchial wall and blood vessels), and allergic bronchopulmonary aspergillosis (an immunological disorder due to hypersensitivity to Aspergillus ) are different manifestations of this fungal disease …”

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confidence: 99%

mentioning

confidence: 99%

Non‐cellular elements in a bronchoalveolar lavage cytology from an immuno‐depressed patient

Martínez‐Girón¹,

Martínez‐Torre

2019

Cytopathology

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Serum galactomannan antigen as a prognostic and diagnostic marker for invasive aspergillosis in heterogeneous medicine ICU patient population

Cited by 14 publications

References 33 publications

Utility of Serum and Bronchoalveolar Lavage Fluid Galactomannan in Diagnosis of Chronic Pulmonary Aspergillosis

Utility of Serum and Bronchoalveolar Lavage Fluid Galactomannan in Diagnosis of Chronic Pulmonary Aspergillosis

Invasive aspergillosis in adult patients with rheumatic diseases

Non‐cellular elements in a bronchoalveolar lavage cytology from an immuno‐depressed patient

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