title: Prospective assessment of Platelia Aspergillus galactomannan antigen for the diagnosis of invasive aspergillosis in lung transplant recipients.
abstract: The clinical utility of Platelia trade mark Aspergillus galactomannan antigen for the early diagnosis of invasive aspergillosis was prospectively assessed in 70 consecutive lung transplant recipients. Sera were collected twice weekly and tested for galactomannan. Invasive aspergillosis was documented in 17.1% (12/70) of the patients. Using the generalized estimating equation model, at the cutoff value of >or= 0.5, the sensitivity of the test was 30%, specificity 93% with positive and negative likelihood ratios of 4.2 and 0.75, respectively. Increasing the cutoff value to >or= 0.66 yielded a sensitivity of 30%, specificity of 95%, and positive and negative likelihood ratios of 5.5 and 0.74. A total of 14 patients had false-positive tests, including nine who had cystic fibrosis or chronic obstructive pulmonary disease. False-positive tests occurred within 3 days of transplantation in 43% (6/14) of the patients, and within 7 days in 64% (9/14). Thus, the test demonstrated excellent specificity, but a low sensitivity for the diagnosis of aspergillosis in this patient population. Patients with cystic fibrosis or chronic obstructive pulmonary disease may transiently have a positive test in the early post-transplant period.
authors.affiliation: University of Pittsburgh Medical Center, Thomas E. Starzl Transplantation Institute, Pittsburgh, PA, USA.
authors.forename: Shahid
authors.initials: S
authors.lastname: Husain
authors.forename: Eun Jeong
authors.initials: EJ
authors.lastname: Kwak
authors.forename: Asia
authors.initials: A
authors.lastname: Obman
authors.forename: Marilyn M
authors.initials: MM
authors.lastname: Wagener
authors.forename: Shimon
authors.initials: S
authors.lastname: Kusne
authors.forename: Janet E
authors.initials: JE
authors.lastname: Stout
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: McCurry
authors.forename: Nina
authors.initials: N
authors.lastname: Singh
mesh_terms: D000328:Adult; D000368:Aged; D000941:Antigens / Q000276:immunology; D001228:Aspergillosis / Q000175:diagnosis* / Q000401:mortality; D001230:Aspergillus / Q000276:immunology*; D005189:False Positive Reactions; D005260:Female; D005690:Galactose / Q000031:analogs & derivatives; D006801:Humans; D007124:Immunoenzyme Techniques; D008168:Lung / Q000382:microbiology*; D016040:Lung Transplantation; D008297:Male; D008351:Mannans / Q000276:immunology; D008875:Middle Aged
chemical_list: D000941:Antigens; D008351:Mannans; C012990:galactomannan; D005690:Galactose