[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.
Wen
Yu-ting
YT
Department of Respirology, Nanjing General Hospital of Nanjing Military Area Command PLA, Nanjing 210002, China.
Zhao
Bei-lei
BL
Lü
Pei-hua
PH
Shi
Yi
Y
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