Galactomannan antigenemia for the diagnosis of invasive aspergillosis in neutropenic patients with hematological disorders.
OBJECTIVE
Invasive aspergillosis (IA) is among the most common invasive fungal infections in neutropenic patients with hematological disorders in the authors' institution, King Chulalongkorn Memorial Hospital (KCMH), Bangkok, Thailand Previous studies have reported the Aspergillus galactomannan enzyme immunosorbent assay (GMEIA) may be a useful diagnostic tool for IA. The authors evaluated the performance of the GM EIA for the diagnosis and monitoring of the course of IA in KCMH.


METHODS
The authors prospectively performed the study from June 2002 to January 2004 in a consecutive series of adult neutropenic patients with hematological disorders who were at risk for developing IA. During hospitalization, serum galactomannan levels were measured once or twice weekly using the Platellia Aspergillus EIA test kit. The sensitivity and specificity of the GM EIA were calculated according to the proportion of patients with true and false positive and negative tests.


RESULTS
There were 50 treatment episodes in 44 patients with 5 proven, 12 probable, and 33 possible or no IA. The cutoff GM index of > 0.75 was determined with a sensitivity of 94.1% and a specificity of 78.8%. There was a close relationship between clinical outcome and the kinetics of GM indices.


CONCLUSIONS
The GM EIA is a useful diagnostic toolfor the diagnosis and monitoring of the course oflA in the presented institute.
Suankratay
Chusana
C
Division of Infectious Diseases, Department of Medicine, Faculty of Medicine Chulalongkorn University, Bangkok 10330, Thailand. chusana.s@chula.ac.th
Kanitcharaskul
Phichai
P
Arunyingmongkol
Kesinee
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000946:Antigens, Fungal / Q000097:blood*; D001228:Aspergillosis / Q000150:complications / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods*; D005260:Female; D005690:Galactose / Q000031:analogs & derivatives; D006402:Hematologic Diseases / Q000150:complications*; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008351:Mannans / Q000097:blood*; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications*; D009894:Opportunistic Infections / Q000150:complications*; D011446:Prospective Studies; D011933:Reagent Kits, Diagnostic; D012306:Risk; D012680:Sensitivity and Specificity
D000946:Antigens, Fungal; D015415:Biomarkers; D008351:Mannans; D011933:Reagent Kits, Diagnostic; C012990:galactomannan; D005690:Galactose