title: Galactomannan in bronchoalveolar lavage fluid for diagnosis of invasive aspergillosis in non-hematological patients.
abstract: The role of galactomannan (GM) in serum or bronchoalveolar lavage fluid (BALF) for the diagnosis of invasive pulmonary aspergillosis (IPA) has been extensively evaluated in hematological patients, however its performance in non-hematological patients is not well established.
  
  
  
  We performed a multicenter retrospective study in 3 university hospitals in Madrid, Spain between 2010 and 2014. The study population comprised patients with chronic obstructive pulmonary disease (COPD) and patients with immunosuppressive conditions in whom IPA was suspected and for whom BALF GM was available. Patients with hematological disorders were excluded.
  
  
  
  A total of 188 patients (35 with COPD and 153 with immunosuppressive conditions) were analyzed, and 31 cases of IPA (proven or probable) were identified. The global sensitivity of BALF GM (optical density index [ODI] ≥ 1.0) was 77.4%; sensitivity was higher in patients with immunosuppressive conditions than in patients with COPD (81.8% vs 66.7%; p: 0.38). In COPD patients, the best performance was obtained for BALF GM (ODI ≥ 0.5), although sensitivity (88.9%) was similar to that of BALF fungal culture (88.9%). The sensitivity of GM in serum was very poor in both populations (36.4% and 11.6%, respectively).
  
  
  
  In the present series, the diagnostic performance of BALF GM was good for IPA in non-hematological patients, especially in patients with immunosuppressive conditions.
authors.affiliation: Department of Infectious Diseases, Hospital Universitario Ramon y Cajal, Instituto de Investigación Ramón y Cajal (IRYCIS), Universidad de Alcalá, Madrid, Spain. Electronic address: fortunabete@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Fortún
authors.affiliation: Department of Infectious Diseases, Hospital Universitario Ramon y Cajal, Instituto de Investigación Ramón y Cajal (IRYCIS), Universidad de Alcalá, Madrid, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Martín-Dávila
authors.affiliation: Department of Microbiology, Hospital Universitario Ramon y Cajal, Instituto de Investigación Ramón y Cajal (IRYCIS), Universidad de Alcalá, Madrid, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Gomez Garcia de la Pedrosa
authors.affiliation: Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre", Universidad Complutense, Madrid, Spain.
authors.forename: J T
authors.initials: JT
authors.lastname: Silva
authors.affiliation: Department of Microbiology, Hospital Universitario La Paz, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Universidad Autónoma, Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Garcia-Rodríguez
authors.affiliation: Department of Infectious Diseases, Hospital Universitario Ramon y Cajal, Instituto de Investigación Ramón y Cajal (IRYCIS), Universidad de Alcalá, Madrid, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Benito
authors.affiliation: Department of Infectious Diseases, Hospital Universitario Ramon y Cajal, Instituto de Investigación Ramón y Cajal (IRYCIS), Universidad de Alcalá, Madrid, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Venanzi
authors.affiliation: Department of Infectious Diseases, Hospital Universitario Ramon y Cajal, Instituto de Investigación Ramón y Cajal (IRYCIS), Universidad de Alcalá, Madrid, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Castaño
authors.affiliation: Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre", Universidad Complutense, Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Fernández-Ruiz
authors.affiliation: Department of Microbiology, Hospital Universitario La Paz, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Universidad Autónoma, Madrid, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Lazaro
authors.affiliation: Department of Pneumology, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre", Universidad Complutense, Madrid, Spain.
authors.forename: R
authors.initials: R
authors.lastname: García-Luján
authors.affiliation: Department of Microbiology, Hospital Universitario La Paz, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Universidad Autónoma, Madrid, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Quiles
authors.affiliation: Department of Pneumology, Hospital Universitario La Paz, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Universidad Autónoma, Madrid, Spain.
authors.forename: J J
authors.initials: JJ
authors.lastname: Cabanillas
authors.affiliation: Department of Infectious Diseases, Hospital Universitario Ramon y Cajal, Instituto de Investigación Ramón y Cajal (IRYCIS), Universidad de Alcalá, Madrid, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Moreno
authors.affiliation: Unit of Infectious Diseases, Hospital Universitario "12 de Octubre", Instituto de Investigación Hospital "12 de Octubre", Universidad Complutense, Madrid, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Aguado
mesh_terms: D000328:Adult; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry* / Q000382:microbiology; D005260:Female; D005690:Galactose / Q000031:analogs & derivatives; D006801:Humans; D016867:Immunocompromised Host; D055744:Invasive Pulmonary Aspergillosis / Q000175:diagnosis* / Q000382:microbiology; D008297:Male; D008351:Mannans / Q000032:analysis* / Q000737:chemistry / Q000302:isolation & purification; D008875:Middle Aged; D009503:Neutropenia; D029424:Pulmonary Disease, Chronic Obstructive; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013030:Spain; D055815:Young Adult
chemical_list: D008351:Mannans; C012990:galactomannan; D005690:Galactose
keywords: Bronchoalveolar lavage fluid; Galactomannan; Invasive aspergillosis