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 â€“ 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 â€“ 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 â€œPlatelia Aspergillus EIAâ€ test depends on the type of biological specimen and was higher than that of classical mycological methods.
Full conference title:
23rd European Congress of Clinical Microbiology and Infectious Diseases