Comparison of serum and bronchoalveolar lavage galactomannan in diagnosing invasive aspergillosis in solid-organ transplant recipients.
OBJECTIVE
This study sought to compare the sensitivities of serum galactomannan and bronchoalveolar lavage galactomannan in diagnosing invasive aspergillosis in solid-organ transplant recipients (lung and heart).


METHODS
This study took place in the lung transplant center of the National Research Institute for Tuberculosis and Lung Disease. All patients with clinical and radiologic manifestations suggestive of pulmonary infection were included. Serum and bronchoalveolar lavage galactomannan were measured.


RESULTS
Seventeen patients were included (lung, 15; heart, 1; heart-lung, 1). Probable or definite invasive aspergillosis was diagnosed in 9 patients. With a cutoff ≥ 0.5, serum galactomannan sensitivity and specificity for diagnosing invasive aspergillosis were 77.18% and 100%. Negative predictive value and positive predictive value were 80% and 100%. The sensitivity and specificity of bronchoalveolar lavage galactomannan for diagnosing invasive aspergillosis with cutoff of ≥ 0.5 was 100%.


CONCLUSIONS
Regarding the high levels of mortality and problems in diagnosing this disease, using bronchoalveolar lavage galactomannan could be a suitable option.
Transplantation Research Center, National Research Institute for Tuberculosis and Lung Disease, Massih Daneshvari Hospital, Shaheed Beheshti University of Medical Science, Tehran, Iran. tabarsi@nritld.ac.ir
Payam
P
Tabarsi
Abdolreza
A
Soraghi
Majid
M
Marjani
Paris
P
Zandian
Parvaneh
P
Baghaei
Katayoon
K
Najafizadeh
Atoosa
A
Droudinia
Shokooh Azam
SA
Sarrafzadeh
Pedram
P
Javanmard
Davood
D
Mansouri
D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000378:metabolism; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry*; D000077336:Caspofungin; D004359:Drug Therapy, Combination; D054714:Echinocandins / Q000627:therapeutic use; D005690:Galactose / Q000031:analogs & derivatives; D016027:Heart Transplantation; D006801:Humans; D055744:Invasive Pulmonary Aspergillosis / Q000175:diagnosis* / Q000188:drug therapy / Q000378:metabolism; D055666:Lipopeptides; D016040:Lung Transplantation; D008297:Male; D008351:Mannans / Q000032:analysis* / Q000097:blood*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011743:Pyrimidines / Q000627:therapeutic use; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014180:Transplantation; D014230:Triazoles / Q000627:therapeutic use; D065819:Voriconazole
D000935:Antifungal Agents; D015415:Biomarkers; D054714:Echinocandins; D055666:Lipopeptides; D008351:Mannans; D011743:Pyrimidines; D014230:Triazoles; C012990:galactomannan; D000077336:Caspofungin; D065819:Voriconazole; D005690:Galactose