title: Performance of Galactomannan Antigen, Beta-d-Glucan, andAspergillus-Lateral-Flow Device for the Diagnosis of Invasive Aspergillosis.
abstract: Aspergilluslateral-flow device (LFD) was recently introduced as a practical tool for the diagnosis of invasive aspergillosis (IA). We investigated the performance ofAspergillus-LFD as a point-of-care test for the diagnosis of IA. Serum samples were collected twice weekly from patients who received intensive chemotherapy for acute leukemia, or recepients of allogeneic stem cell transplantation. Aspergillus galactomannan (GM) antigen, 1,3-beta-d-glucan andAspergillus-LFD tests were carried out according to manufacturers' recommendations. GM testing was repeated with a modified procedure which was proven to increase the sensitivity.Aspergillus-LFD was performed without applying any pretreatment procedure to allow the kit to fit as a point-of-care test. Fungal infections were categorized according to European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) criteria. A total of 75 neutropenia episodes in 64 patients were prospectively followed between February 2012 and January 2013. Probable IA was diagnosed in 11 patients, probable pulmonary fungal disease was diagnosed in one patient, and rhinocerebral aspergillosis was diagnosed in one patient. Fungemia was detected in two patients.Aspergillus-LFD was positive in serum of a patient with probable IA and in the bronchoalveolar lavage fluid of an other patient with probable IA.Aspergillus-LFD was false positive in serum of two patients. Although there was no radiological finding of IA or documented fungemia, fever resolved after empirical caspofungin therapy in one of these patients. The sensitivity ofAspergillus-LFD as a point-of-care test without any pretreatment of serum sample is low.
authors.affiliation: Departments of Infectious Diseases, Faculty of Medicine, Erciyes University, Kayseri, Turkey.|Enfeksiyon Hastalıkları Anabilim Dalı, Hacettepe Üniversitesi Tıp Fakültesi, İç Hastalıkları Binası, Kat:1, Sıhhıye, 06100 Ankara, Turkey.
authors.forename: Gökhan
authors.initials: G
authors.lastname: Metan
authors.affiliation: Departments of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors.forename: Muzaffer
authors.initials: M
authors.lastname: Keklik
authors.affiliation: Departments of Clinical Microbiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors.forename: Gökçen
authors.initials: G
authors.lastname: Dinç
authors.affiliation: Departments of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors.forename: Çiğdem
authors.initials: Ç
authors.lastname: Pala
authors.affiliation: Departments of Radiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors.forename: Afra
authors.initials: A
authors.lastname: Yıldırım
authors.affiliation: Departments of Immunology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.|Kök-Biotechnics, Erciyes Technopark, Kayseri, Turkey.
authors.forename: Berkay
authors.initials: B
authors.lastname: Saraymen
authors.affiliation: Departments of Immunology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.|Kök-Biotechnics, Erciyes Technopark, Kayseri, Turkey.
authors.forename: Mustafa Yavuz
authors.initials: MY
authors.lastname: Köker
authors.affiliation: Departments of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors.forename: Leylagül
authors.initials: L
authors.lastname: Kaynar
authors.affiliation: Departments of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors.forename: Bülent
authors.initials: B
authors.lastname: Eser
authors.affiliation: Departments of Hematology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Çetin
keywords: 1,3-beta-d-glucan; Aspergillus; Fungemia; Galactomannan; Invasive aspergillosis; Invasive fungal infection; LFD; Lateral flow device