title: Serum galactomannan levels in the diagnosis of invasive aspergillosis.
abstract: OBJECTIVE
  In this study, the sensitivity-specificity of galactomannan-enzyme immunoassay (GM-EIA) with a cut-off value of 0.5 for a single, two, or three consecutive positivity in the diagnosis of invasive pulmonary aspergillosis (IPA) in neutropenic patients with hematological malignancy was investigated.
  
  
  METHODS
  IPA was classified as "proven," "probable," or "possible" as described in the guidelines prepared by the European Organization for Research and Treatment of Cancer and Mycoses Study Group." Serum samples were collected from the patients twice a week throughout their hospitalization. A total of 1,385 serum samples, with an average of 8.3 samples per episode, were examined.
  
  
  RESULTS
  Based on the 165 febrile episodes in 106 patients, 80 (48.5%) were classified as IPA (4 proven, 11 probable, 65 possible) and 85 (51.5%) as non-IPA. The sensitivity/ specificity was 100%/27.1% for a single proven/probable IPA with the cut of value of GM-EIA ≥ 0.5, 86.7%/71.8% for two consecutive positive results, and 73.3%/85.9% for three consecutive positive results.
  
  
  CONCLUSIONS
  With the galactomannan levels measured twice a week, consecutive sensitivity decreased and specificity increased. Therefore, an increase may be obtained in sensitivity-specificity by more frequent monitoring of GM-EIA starting from the first day of positivity is detected.
authors.affiliation: Department of Internal Medicine, Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey.
authors.forename: Yildiz
authors.initials: Y
authors.lastname: Okuturlar
authors.affiliation: Department of Hematology, Uludag University Faculty of Medicine, Bursa, Turkey.
authors.forename: Fahir
authors.initials: F
authors.lastname: Ozkalemkas
authors.affiliation: Departments of Medical Mycology and Microbiology, Uludag University Faculty of Medicine, Bursa, Turkey.
authors.forename: Beyza
authors.initials: B
authors.lastname: Ener
authors.affiliation: Department of Internal Medicine, Umraniye Education and Research Hospital, Istanbul, Turkey.
authors.forename: Sibel Ocak
authors.initials: SO
authors.lastname: Serin
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Uludag University Faculty of Medicine, Bursa, Turkey.
authors.forename: Esra
authors.initials: E
authors.lastname: Kazak
authors.affiliation: Bone Marrow Transplantation Center, Florence Nightingale Hospital, Istanbul, Turkey.
authors.forename: Tulay
authors.initials: T
authors.lastname: Ozcelik
authors.affiliation: Department of Hematology, Uludag University Faculty of Medicine, Bursa, Turkey.
authors.forename: Vildan
authors.initials: V
authors.lastname: Ozkocaman
authors.affiliation: Department of Hematology, Yeditepe University Faculty of Medicine, Istanbul, Turkey.
authors.forename: Hasan Atilla
authors.initials: HA
authors.lastname: Ozkan
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Uludag University Faculty of Medicine, Bursa, Turkey.
authors.forename: Halis
authors.initials: H
authors.lastname: Akalin
authors.affiliation: Department of Oncology, Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Istanbul, Turkey.
authors.forename: Meral
authors.initials: M
authors.lastname: Gunaldi
authors.affiliation: Department of Hematology, Uludag University Faculty of Medicine, Bursa, Turkey.
authors.forename: Ridvan
authors.initials: R
authors.lastname: Ali
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005690:Galactose / Q000031:analogs & derivatives; D019337:Hematologic Neoplasms / Q000175:diagnosis / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D055744:Invasive Pulmonary Aspergillosis / Q000097:blood* / Q000175:diagnosis / Q000276:immunology / Q000382:microbiology; D008297:Male; D008351:Mannans / Q000097:blood*; D008875:Middle Aged; D009894:Opportunistic Infections / Q000097:blood* / Q000175:diagnosis / Q000276:immunology / Q000382:microbiology; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; D007166:Immunosuppressive Agents; D008351:Mannans; C012990:galactomannan; D005690:Galactose
keywords: Cut-off value; Enzyme-linked immunosorbent assay; Galactomannan test; Invasive aspergillosis; Sensitivity and specificity