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Diagnostic yield of a bronchoalveolar lavage fluid galactomannan assay in patients with negative serum galactomannan results suspected to have invasive pulmonary aspergillosis.
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- Author(s): Lim SY;Lim SY; Lee YW; Lee YW; Jung J; Jung J; Kim MJ; Kim MJ; Chong YP; Chong YP; Lee SO; Lee SO; Choi SH; Choi SH; Kim YS; Kim YS; Choi EJ; Choi EJ; Park HS; Park HS; Lee JH; Lee JH; Lee JH; Lee JH; Lee KH; Lee KH; Kim SH; Kim SH
- Source:
Mycoses [Mycoses] 2021 Sep; Vol. 64 (9), pp. 1124-1131. Date of Electronic Publication: 2021 May 24.- Publication Type:
Journal Article- Language:
English - Source:
- Additional Information
- Source: Publisher: Grosse Verlag Country of Publication: Germany NLM ID: 8805008 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1439-0507 (Electronic) Linking ISSN: 09337407 NLM ISO Abbreviation: Mycoses Subsets: MEDLINE
- Publication Information: Original Publication: Berlin : Grosse Verlag, [1988?-
- Subject Terms: Invasive Pulmonary Aspergillosis*/diagnosis; Galactose/*analogs & derivatives ; Mannans/*analysis; Bronchoalveolar Lavage Fluid/chemistry ; Galactose/analysis ; Galactose/blood ; Humans ; Mannans/blood ; Negative Results ; Republic of Korea ; Retrospective Studies ; Sensitivity and Specificity ; Tertiary Care Centers
- Abstract: Background and Objectives: There are limited data in real clinical practice on the diagnostic value of a bronchoalveolar lavage (BAL) fluid galactomannan (GM) assay in patients with suspected invasive pulmonary aspergillosis (IPA) who had negative serum GM results. Thus, we investigated the diagnostic performance of a BAL GM assay in patients with negative serum GM assay results who were suspected to have IPA.
Methods: This retrospective study was performed between May 2008 and April 2019 at a tertiary-care hospital in Seoul, South Korea. All patients with suspected IPA whose serum GM assays revealed negative results who sequentially underwent BAL were enrolled in this study.
Results: A total of 341 patients with suspected IPA including four cases of proven IPA, 38 cases of probable IPA, 107 cases of possible IPA and 192 patients without IPA were enrolled. Of these 341 patients, 107 (31%) with possible IPA were excluded from the final analysis. Of 42 patients with proven and probable IPA who had initial negative serum GM results, 24 (57%) had positive BAL GM results (n = 24) or BAL fungal culture results (n = 8). In addition, BAL revealed evidence of other opportunistic infections including Pneumocystis jirovecii pneumonia (14% [26/190]), cytomegalovirus (CMV) pneumonia (5% [9/188]) and respiratory viral pneumonia (6% [12/193]).
Conclusion: Sequential BAL in patients with suspected IPA who had initial negative serum GM results provided additional diagnostic yield in approximately half of patients with evidence of another co-infection.
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Adam O, Aupérin A, Wilquin F, Bourhis JH, Gachot B, Chachaty E. Treatment with piperacillin-tazobactam and false-positive Aspergillus galactomannan antigen test results for patients with hematological malignancies. Clin Infect Dis. 2004;38(6):917-920.
Singh N, Obman A, Husain S, Aspinall S, Mietzner S, Stout JE. Reactivity of platelia Aspergillus galactomannan antigen with piperacillin-tazobactam: clinical implications based on achievable concentrations in serum. Antimicrob Agents Chemother. 2004;48(6):1989-1992. - Grant Information: Korea Health Industry Development Institute; HI20C0073 Ministry of Health & Welfare, Republic of Korea
- Contributed Indexing: Keywords: antifungal agents; aspergillosis; bronchoalveolar lavage; galactomannan; immunocompromised host; invasive fungal infections; invasive pulmonary aspergillosis; opportunistic infection
- Accession Number: 0 (Mannans)
11078-30-1 (galactomannan)
X2RN3Q8DNE (Galactose) - Publication Date: Date Created: 20210319 Date Completed: 20220106 Latest Revision: 20220106
- Publication Date: 20240628
- Accession Number: 10.1111/myc.13269
- Accession Number: 33740824
- Source:
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