Comparative performance of the Platelia Aspergillus Antigen and Aspergillus Galactomannan antigen Virclia Monotest immunoassays in serum and lower respiratory tract specimens: a "real-life" experience.

Autor:	Albert E; Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain., Alcaraz MJ; Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain., Giménez E; Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain., Clari MÁ; Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain., Torres I; Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain., Colomina J; Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain., Olea B; Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain., Tormo M; Hematology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain., Piñana JL; Hematology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain., Oltra R; Infectious Diseases Unit, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain., Signes-Costa J; Pulmonary Department, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain., Carbonell N; Medical Intensive Care Unit, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain., Solano C; Hematology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain.; Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain., Navarro D; Microbiology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain.; Department of Microbiology School of Medicine, University of Valencia, Valencia, Spain.; CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain.
Jazyk:	angličtina
Zdroj:	Microbiology spectrum [Microbiol Spectr] 2024 Aug 06; Vol. 12 (8), pp. e0391023. Date of Electronic Publication: 2024 Jun 25.
DOI:	10.1128/spectrum.03910-23
Abstrakt:	The Platelia Aspergillus Antigen immunoassay is the "gold standard" for Aspergillus galactomannan (GLM) measurement in sera and bronchoalveolar lavage (BAL) for the diagnosis of invasive pulmonary aspergillosis (IPA). We evaluated the performance of the Aspergillus GLM antigen Virclia Monotest compared to the Platelia assay. A total of 535 specimens [320 sera, 86 bronchial aspirates (BAs), 70 BAL, and 59 tracheal aspirates (TAs)] from 177 adult patients (72 hematological, 32 Intensive Care Unit, and 73 hospitalized in other wards) were processed for GLM testing upon clinical request. One patient had proven IPA, and 11 had probable disease. After excluding indeterminate Virclia results ( n = 38), 396 specimens yielded concordant results (56 positive and 340 negative) and 101 discordant results (Virclia positive/Platelia negative, n = 95). The overall agreement between immunoassays was higher for sera ( κ 0.56) than for BAL ( κ ≤ 0.24) or BAS and TA ( κ ≤ 0.22). When considering all specimen types in combination, the overall sensitivity and specificity of the Virclia assay for the diagnosis of proven/probable IPA were 100% and 65%, respectively, and for the Platelia immunoassay, sensitivity and specificity were 91.7% and 89.4%, respectively. The correlation between index values by both immunoassays was strong for serum/BAL ( ρ = 0.73; P < 0.001) and moderate for BAS/TA (Rho = 0.52; P = 0.001). The conversion of Virclia index values into the Platelia index could be derived by the formula y = (11.97 * X )/3.62 + X ). Data from GLM-positive serum/BAL clinical specimens fitted the regression model optimally ( R 2 = 0.94), whereas that of BAS and TA data did not ( R 2 = 0.11). Further studies are needed to determine whether the Virclia assay may be an alternative to the Platelia assay for GLM measurement in sera and lower respiratory tract specimens.IMPORTANCEGalactomannan detection in serum or bronchoalveolar fluid specimens is pivotal for the diagnosis of invasive pulmonary aspergillosis (IPA). The Platelia Aspergillus Antigen immunoassay has become the "gold standard" for Aspergillus GLM measurement. Here, we provide data suggesting that the Virclia Monotest assay, which displays several operational advantages compared with the Platelia assay, may become an alternative to the Platelia assay, although further studies are needed to validate this assumption. We also provide a formula allowing the conversion of Virclia index values into Platelia values. The study may contribute toward positioning the Virclia assay within the diagnostic algorithm of IPA. Competing Interests: The authors declare no conflict of interest.
Databáze:	MEDLINE
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