Galactomannan testing for diagnosis of invasive aspergillosis in patients with haematological malignancies in Saint Petersburg, Russia

S.M. Ignatyeva*, V.A. Spiridonova, T.S. Bogomolova, A.G. Volkova, O.V. Shadrivova, Y.V. Borzova, S.N. Khostelidi, E.A. Desyatik, M.O. Popova, A.S. Kolbin, I.S. Zjuzgin, A.V. Klimovich, N.V. Vasilyeva, L.S. Zubarovskaja, B.V. Afanasyev, N.N. Klimko


Objectives: The aim of the study was to analyze the utility of galactomannan(GM)test in the diagnosis of IA in patients with hematological malignancies in St.Petersburg, Russia. Methods: The study included 258 samples:140 serum and 118 bronchoalveolar lavage fluid (BAL) from 89 hematological patients with IA in 19 hospitals in St.Petersburg in 2011-2012yy.Control group included hematological patients without IA (216 samples).Detection of GM was performed with Platelia Aspergillus EIA (Bio-Rad). The test was considered as positive with a cut-off of >= 0,5 (serum)and >= 1,0 (BAL). Results: GM test was positive in 83 serum and 87 BAL samples of patients IA. Level of GM index in serum was 0,5 – 2,7 and increased in BAL samples up to 7,5. Sensitivity and specificity of GM test in serum were 0,59 (95%CI, 0,53-0,66) and 0,86 (95%CI, 0,72-0,90), respectively. The prognostic value of positive and negative result of the test were 0,77 (95%CI 0,71-0,87) and 0,86 (95%CI 0,83-0,88), respectively. Sensitivity and specificity of GM test in BAL were 0,74 (95%CI 0,64-0,84) and 0,83 (95%CI 0,78-0,88), respectively. The positive result of GM test in BAL samples and serum samples correlated with positive results of microscopy and culture of BAL in 60% and 30%, respectively. In hematological patients with IA a higher level GM index (2,0 – 7,5) was found in the BAL samples more frequently along with a positive microscopy than with positive mycological culture. Conclusion: This study indicates that GM test in serum and BAL has a significant impact on the diagnostics of IA in patients with hematologic malignancies. The sensitivity of “Platelia Aspergillus EIA” test depends on the type of biological specimen and was higher than that of classical mycological methods.

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23rd European Congress of Clinical Microbiology and Infectious Diseases