Comparison of serum and bronchoalveolar lavage galactomannan in diagnosing invasive aspergillosis in solid-organ transplant recipients

Exp Clin Transplant. 2012 Jun;10(3):278-81. doi: 10.6002/ect.2011.0176.

Abstract

Objectives: This study sought to compare the sensitivities of serum galactomannan and bronchoalveolar lavage galactomannan in diagnosing invasive aspergillosis in solid-organ transplant recipients (lung and heart).

Materials and methods: This study took place in the lung transplant center of the National Research Institute for Tuberculosis and Lung Disease. All patients with clinical and radiologic manifestations suggestive of pulmonary infection were included. Serum and bronchoalveolar lavage galactomannan were measured.

Results: Seventeen patients were included (lung, 15; heart, 1; heart-lung, 1). Probable or definite invasive aspergillosis was diagnosed in 9 patients. With a cutoff ≥ 0.5, serum galactomannan sensitivity and specificity for diagnosing invasive aspergillosis were 77.18% and 100%. Negative predictive value and positive predictive value were 80% and 100%. The sensitivity and specificity of bronchoalveolar lavage galactomannan for diagnosing invasive aspergillosis with cutoff of ≥ 0.5 was 100%.

Conclusions: Regarding the high levels of mortality and problems in diagnosing this disease, using bronchoalveolar lavage galactomannan could be a suitable option.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antifungal Agents / therapeutic use
  • Biomarkers / metabolism
  • Bronchoalveolar Lavage Fluid / chemistry*
  • Caspofungin
  • Drug Therapy, Combination
  • Echinocandins / therapeutic use
  • Galactose / analogs & derivatives
  • Heart Transplantation*
  • Humans
  • Invasive Pulmonary Aspergillosis / diagnosis*
  • Invasive Pulmonary Aspergillosis / drug therapy
  • Invasive Pulmonary Aspergillosis / metabolism
  • Lipopeptides
  • Lung Transplantation*
  • Male
  • Mannans / analysis*
  • Mannans / blood*
  • Middle Aged
  • Predictive Value of Tests
  • Prospective Studies
  • Pyrimidines / therapeutic use
  • Retrospective Studies
  • Sensitivity and Specificity
  • Transplantation*
  • Triazoles / therapeutic use
  • Voriconazole

Substances

  • Antifungal Agents
  • Biomarkers
  • Echinocandins
  • Lipopeptides
  • Mannans
  • Pyrimidines
  • Triazoles
  • galactomannan
  • Caspofungin
  • Voriconazole
  • Galactose