title: Utility of the Aspergillus galactomannan antigen testing for neutropenic paediatric patients.
abstract: Invasive aspergillosis (IA) is an increasingly important cause of morbidity and mortality particularly in paediatric patients. Early diagnosis and the initiation of efficacious antifungal treatments could affect the prognosis of these patients. The aim of this study was to determine the clinical contribution of Galactomannan (GM) screening in paediatric patients. We reviewed the records of all in-patients, and followed up, in the various units at the Medical Faculty Children's Hospital of Erciyes University (Kayseri, Turkey), those who had at least one GM assay result from August 2009 to April 2012. Paediatric patients were classified as proven, probable or possible, according to the European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG). Twenty-five patients, with proven IA (n=3), probable IA (n=9) and possible IA (n=13) were included in the study. The GM antigen assay results were analysed in 158 blood samples from 47 patients. At the cut-off value of 0.5 ng/ml, the sensitivity was 68% [95% confidence interval (CI); 47-85]; specificity, 77% (95% CI; 55-92). To obtain more accurate results with GM testing, the diagnosis of IA should be confirmed by clinical investigation and the factors causing false positivity of the test should also be considered.
authors.affiliation: Department of Clinical Microbiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors.forename: Hafize
authors.initials: H
authors.lastname: Sav
authors.affiliation: Department of Clinical Microbiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors.forename: Mustafa Altay
authors.initials: MA
authors.lastname: Atalay
authors.affiliation: Department of Clinical Microbiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors.forename: Ayse Nedret
authors.initials: AN
authors.lastname: Koc
authors.affiliation: Department of Department of Paediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors.forename: Ekrem
authors.initials: E
authors.lastname: Unal
authors.affiliation: Department of Clinical Microbiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
authors.forename: Gonca
authors.initials: G
authors.lastname: Demir
authors.affiliation: Department of Biostatistics, Faculty of Medicine, University of Erciyes, Kayseri, Turkey.
authors.forename: Gokmen
authors.initials: G
authors.lastname: Zararsiz
mesh_terms: D000293:Adolescent; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D019337:Hematologic Neoplasms / Q000150:complications*; D006776:Hospitals, Pediatric; D006785:Hospitals, University; D006801:Humans; D016867:Immunocompromised Host; D007223:Infant; D008297:Male; D008351:Mannans / Q000097:blood*; D008403:Mass Screening / Q000379:methods; D009503:Neutropenia; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014421:Turkey / Q000453:epidemiology
chemical_list: D000935:Antifungal Agents; D015415:Biomarkers; D008351:Mannans