Non-invasive detection of Aspergillosis in ventilated patients: Galactomannan analysis in exhaled breath

Diagn Microbiol Infect Dis. 2024 Sep;110(1):116420. doi: 10.1016/j.diagmicrobio.2024.116420. Epub 2024 Jun 29.

Abstract

This study evaluates the non-invasive diagnosis of Invasive Aspergillosis Pneumonia (IPA) in mechanically ventilated patients by measuring galactomannan (GM) in exhaled breath condensate (EBC). Utilizing a rat model and a novel EBC collection device, we compared GM levels in bronchoalveolar lavage fluid (BALF) and EBC, supplemented by cytokine profiling. Analysis of 75 patients confirmed the device's efficacy, with EBC-GM and BALF-GM showing high diagnostic accuracy (AUC = 0.88). The threshold of 0.235 ng/ml for EBC-GM achieved 92.8 % sensitivity and 66.7 % specificity, with a strong correlation (r = 0.707, P < 0.001) with BALF-GM. This approach offers a safe, effective alternative to invasive diagnostics, enhancing precision with IL-6 and TNF-α measurements. The number registered on clinicaltrails.gov is NCT06333379.

Keywords: Bronchoalveolar lavage fluid; Diagnosis; Exhaled breath condensate; Galactomannan; Invasive pulmonary aspergillosis; Non-invasive.

MeSH terms

  • Aged
  • Animals
  • Breath Tests* / methods
  • Bronchoalveolar Lavage Fluid* / chemistry
  • Bronchoalveolar Lavage Fluid* / microbiology
  • Cytokines / analysis
  • Cytokines / metabolism
  • Exhalation
  • Female
  • Galactose* / analogs & derivatives
  • Humans
  • Invasive Pulmonary Aspergillosis / diagnosis
  • Male
  • Mannans* / analysis
  • Middle Aged
  • Rats
  • Respiration, Artificial / adverse effects
  • Sensitivity and Specificity*

Substances

  • Mannans
  • galactomannan
  • Galactose
  • Cytokines

Associated data

  • ClinicalTrials.gov/NCT06333379