Galactomannan in bronchoalveolar lavage fluid for diagnosis of invasive aspergillosis in non-hematological patients
| Autor: | E. Venanzi, J.J. Cabanillas, Julio García-Rodríguez, Pilar Martín-Dávila, José Tiago Silva, R. García-Luján, Mario Fernández-Ruiz, D. Benito, F. Lazaro, E. Gomez Garcia de la Pedrosa, Jesús Fortún, José María Aguado, F. Castaño, I. Quiles, Santiago Moreno |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male 0301 basic medicine Microbiology (medical) Pathology medicine.medical_specialty Neutropenia 030106 microbiology Aspergillosis Sensitivity and Specificity Gastroenterology Article Mannans Immunocompromised Host Pulmonary Disease Chronic Obstructive Young Adult 03 medical and health sciences Galactomannan chemistry.chemical_compound Internal medicine Humans Medicine In patient Retrospective Studies Invasive Pulmonary Aspergillosis COPD medicine.diagnostic_test business.industry Galactose Retrospective cohort study Middle Aged respiratory system University hospital medicine.disease respiratory tract diseases Infectious Diseases Bronchoalveolar lavage chemistry Spain Population study Female business Bronchoalveolar Lavage Fluid |
| Zdroj: | Journal of Infection. 72:738-744 |
| ISSN: | 0163-4453 |
| DOI: | 10.1016/j.jinf.2016.02.019 |
| Popis: | Summary Background The role of galactomannan (GM) in serum or bronchoalveolar lavage fluid (BALF) for the diagnosis of invasive pulmonary aspergillosis (IPA) has been extensively evaluated in hematological patients, however its performance in non-hematological patients is not well established. Methods We performed a multicenter retrospective study in 3 university hospitals in Madrid, Spain between 2010 and 2014. The study population comprised patients with chronic obstructive pulmonary disease (COPD) and patients with immunosuppressive conditions in whom IPA was suspected and for whom BALF GM was available. Patients with hematological disorders were excluded. Results A total of 188 patients (35 with COPD and 153 with immunosuppressive conditions) were analyzed, and 31 cases of IPA (proven or probable) were identified. The global sensitivity of BALF GM (optical density index [ODI] ≥ 1.0) was 77.4%; sensitivity was higher in patients with immunosuppressive conditions than in patients with COPD (81.8% vs 66.7%; p: 0.38). In COPD patients, the best performance was obtained for BALF GM (ODI ≥ 0.5), although sensitivity (88.9%) was similar to that of BALF fungal culture (88.9%). The sensitivity of GM in serum was very poor in both populations (36.4% and 11.6%, respectively). Conclusions In the present series, the diagnostic performance of BALF GM was good for IPA in non-hematological patients, especially in patients with immunosuppressive conditions. |
| Databáze: | OpenAIRE |
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