title: Comparative evaluation of galactomannan optical density indices and culture results in bronchoscopic specimens obtained from neutropenic and non-neutropenic patients.
abstract: Aspergillus infections are major causes of morbidity and mortality among immunocompromised patients. This study was designed to investigate the galactomannan assay optical density (OD) indices relative to the culture results in bronchoscopic samples obtained from neutropenic and non-neutropenic patients. Galactomannan OD indices from 1427 samples from 2005 to 2012, which were sent from 839 patients and were composed of bronchial lavage (BL = 727) and bronchoalveolar lavage fluids (BAL = 700), were retrospectively analysed. The recovery rates of Aspergillus species from these specimens were 9.4% from the combined patient group and 13.3% from the neutropenic group. Aspergillus fumigatus complex was the most frequently isolated species. The mean and median OD indices of the positive and negative culture samples are approximately 5 and 1, respectively, and 91% of all culture-positive samples have ≥1 OD index value. The receiver-operating characteristics curve analysis demonstrated that the feasibility of the Aspergillus galactomannan assay and Aspergillus galactomannan test has superior accuracy in BAL compared to BL fluids, and the test is not affected by the immune status of the patient. We suggest that the Aspergillus galactomannan test, which uses bronchoscopic material, leads to an earlier diagnosis and if the OD index is found ≥1, fungal growth can be expected.
authors.affiliation: Department of Medical Microbiology, Faculty of Medicine, Uludag University, Bursa, Turkey.
authors.forename: Harun
authors.initials: H
authors.lastname: Ağca
authors.forename: Beyza
authors.initials: B
authors.lastname: Ener
authors.forename: Emel
authors.initials: E
authors.lastname: Yılmaz
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ursavaş
authors.forename: Esra
authors.initials: E
authors.lastname: Kazak
authors.forename: Vildan
authors.initials: V
authors.lastname: Özkocaman
authors.forename: Ezgi Demirdöğen
authors.initials: ED
authors.lastname: Çetinoğlu
authors.forename: Aslı Görek
authors.initials: AG
authors.lastname: Dilektaşlı
authors.forename: Halis
authors.initials: H
authors.lastname: Akalın
authors.forename: Fahir
authors.initials: F
authors.lastname: Özkalemkaş
authors.forename: Rıdvan
authors.initials: R
authors.lastname: Ali
mesh_terms: D001228:Aspergillosis / Q000175:diagnosis; D001232:Aspergillus fumigatus / Q000302:isolation & purification*; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D005690:Galactose / Q000031:analogs & derivatives; D019337:Hematologic Neoplasms / Q000382:microbiology; D006801:Humans; D008172:Lung Diseases, Fungal / Q000175:diagnosis*; D008351:Mannans / Q000737:chemistry*; D009503:Neutropenia / Q000378:metabolism* / Q000382:microbiology; D012189:Retrospective Studies; D013048:Specimen Handling
chemical_list: D008351:Mannans; C012990:galactomannan; D005690:Galactose
keywords: Aspergillus; culture; galactomannan