| DB ID | MyCo_2674 |
| Title | Direct comparison of galactomannan performance in concurrent serum and bronchoalveolar lavage samples in immunocompromised patients at risk for invasive pulmonary aspergillosis |
| Year | 2015 |
| PMID | 26627577 |
| Fungal Diseases involved | Invasive pulmonary aspergillosis |
| Associated Medical Condition | None |
| Genus | Aspergillus |
| Species | fumigatus |
| Organism | Aspergillus fumigatus |
| Ethical Statement | As the study was done to retrospectively investigate the clinical data of patients treated solely at our institution in a scientific intent and data were obtained anonymised concurrently, an approval of the local ethics committee (Ethics Committee, Faculty of Medicine Mannheim) was not required according to the German Ethics Committees regulations. The study was performed in compliance with the Declaration of Helsinki. |
| Site of Infection | Lungs |
| Opportunistic invasive | Opportunistic |
| Sample type | Body fluid |
| Sample source | Bronchoalveolar lavage fluid (BALF) |
| Host Group | Human |
| Host Common name | Human |
| Host Scientific name | Homo sapiens |
| Biomarker Name | GM |
| Biomarker Full Name | Galactomannan |
| Biomarker Type | Diagnostic |
| Biomolecule | Protein |
| Geographical Location | Germany |
| Cohort | The study was performed retrospectively on a cohort of unselected consecutive patients treated in the Hematology Department of the University Hospital of Mannheim with the majority suffering from malignant haematological diseases between 2004 and 2014. The patients’ records were analysed for recipients of bronchoscopy with bronchoalveolar lavage for whom GM tests were performed in BAL and in serum within a time frame of no longer than 24 h. Patients were classified as proven, probable, possible and no IPA according to the European Organization for the Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) consensus definitions. The majority of patients suffered from malignant haematological diseases. Two patients suffered from HIV infection with consecutive immunodeficiency. Four patients were recipients of solid organ transplants and received immunosuppressants. Two patients received allogeneic stem cell transplantation. |
| Cohort No. | 34 |
| Age Group | 22-79 |
| P Value | p<0.0002 |
| Sensitivity | 0.85 |
| Specificity | 0.88 |
| Positive Predictive Value | 0.96 |
| MIC | None |
| Fold Change | None |
| Pathway | None |
| Disease Introduction Mechanism | Invasive fungal diseases (IFD) represent severe, lifethreatening complications in immunocompromised patients, especially in patients with haematological malignancies receiving intensive chemotherapy or undergoing allogeneic hematopoietic stem cell transplantation.1–4 Invasive pulmonary Aspergillosis (IPA) is the most common cause of mortality due to mould disease. The diagnostic gold standard consists of positive culture or histology findings that define proven disease. However, low sensitivity and/or specificity rates and a considerable time lag in detection of IFD limit the clinical value.2,5,6 Early treatment and mould-active antifungal prophylaxis or therapy (AFP/ AFT) are prognostically crucial, but reduce the pathogen load and therefore the sensitivity rate of the diagnostic tools, and methods which overcome this diagnostic difficulty are urgently needed.7,8 In many haematological high-risk cases, AFT is begun empirically or pre-emptively, solely based on host factors, fever or suspicious chest CT scans. This approach, however, is not without critique, as biopsybased studies have shown only about half of these patients suffering from IPA.9 Detecting and identifying the underlying fungal pathogen is of significant clinical importance, has prognostic and therapeutic implications and represents an unmet clinical need. |
| Technique | ELISA |
| Analysis Method | ELISA Based |
| ELISA kits | Platelia Aspergillus ELISA assay Kit (Bio-Rad, Munich, Germany) |
| Assay Data | None |
| Validation Techniques used | ELISA |
| Up Regulation Down Regulation | Increase |
| Sequence Data | None |
| External Link | None |
