[Evaluation of the galactomannan assay for the diagnosis of invasive aspergillosis in patients].
OBJECTIVE
To assess the value of Aspergillus galactomannan (GM) double-direct sandwich enzyme-linked immunosorbent assay (ELISA) in the diagnosis of invasive aspergillosis (IA).


METHODS
Forty nine patients were divided into IA group (n = 11), other invasive fungal infection group (n = 20) and Aspergillus colonization group (n = 18). The serum samples of all patients and 6 patients with IA after 7 day treatment were used for GM detection. A double-direct sandwich ELISA was employed to detect GM optical density index (ODI) in the serum samples. Measurement data followed the Gaussian distribution were expressed as x +/- s. Differences among groups were tested using a one factor analysis of variance. The significance of variation before and after therapy was tested with paired t test. P < 0.05 were considered to represent a significant difference. Statistical analyses were performed by SPSS statistical package.


RESULTS
The serum GM ODI in IA patients was higher (1.63 +/- 0.29) than that in other IFI patients (0.96 +/- 0.49) and Aspergillus colonization patients (0.83 +/- 0.43) , F = 12.681, P < 0.05. The serum GM ODI of 6 patients with IA before and after treatment were 1.67 +/- 0.24 and 1.62 +/- 0.28 (t = 0.475, P > 0.05), respectively. If the cutoff GM ODI was 1.5, the sensitivity, specificity, positive predictive value and negative predictive value for diagnosis of IA in the patients were 72.7% , 84.2%, 57.1% and 94.1%, respectively.


CONCLUSIONS
The serum GM detection has diagnostic value for IA and could distinguish Aspergillus infection from other invasive fungal infections and Aspergillus colonization. A cutoff GM ODI of 1.5 showed the best sensitivity and specificity for IA in the patients.
Department of Respirology, Nanjing General Hospital of Nanjing Military Area Command PLA, Nanjing 210002, China.
Yu-ting
YT
Wen
Bei-lei
BL
Zhao
Pei-hua
PH
Lü
Yi
Y
Shi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005690:Galactose / Q000031:analogs & derivatives; D006801:Humans; D055744:Invasive Pulmonary Aspergillosis / Q000175:diagnosis*; D008297:Male; D008351:Mannans / Q000097:blood*; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D055815:Young Adult
D008351:Mannans; C012990:galactomannan; D005690:Galactose