Performance of the galactomannan test for the diagnosis of invasive pulmonary aspergillosis using non-invasive proximal airway samples

• DOI: 10.1016/j.jinf.2024.106159
• Publication Date: 2024-04-18T02:06:39Z
• Authors: June Young Chun; Sahng-Joon Jeong; Sinae Kim; Soyoung Choi; Jong Hyuk Lee; Hyun Sung Chung; Seungman Park; Hyewon Lee; Hyae Young Kim; Bin Hwangbo; Young Ju Choi
• Keywords: Galactomannan

ObjectiveTo diagnose invasive pulmonary aspergillosis (IPA), galactomannan (GM) detection in serum or bronchoalveolar lavage fluid (BALF) is widely used. However, the utility of proximal airway GM test (from induced sputum tracheal aspirate) has not been well elucidated.MethodsIn this retrospective cohort study, we evaluated diagnostic performance diagnosis IPA including COVID-19 associated (CAPA). Between January 2022 and 2023, patients who had tested for with clinical suspicion surveillance from any specimen (serum, sputum, aspirate, BALF) were screened. was diagnosed using EORTC/MSGERC criteria, CAPA following 2020 ECMM/ISHAM consensus criteria.ResultsOf 624 results, 70 met criteria proven/probable 427 no IPA. The others included possible chronic form aspergillosis. sensitivities specificities serum, airway, BALF versus 78.9% 70.6%, 93.1% 78.7%, 78.6% 91.0%, respectively. Areas under receiver operating characteristic curve (AUCs) 0.742 GM, 0.935 0.849 (serum vs p = 0.014; 0.334; 0.286).ConclusionThis study demonstrates that non-invasive samples comparable even better than those distal sample (BALF).