Comparison of β-D-Glucan and Galactomannan in Serum for Detection of Invasive Aspergillosis: Retrospective Analysis with Focus on Early Diagnosis
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Study Population
3.2. Sensitivity and Specificity of Tests
3.3. Time Point of Seropositivity
4. Discussion
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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n | % | |
---|---|---|
all serum samples | 380 | 100 |
serum samples of IA cases | 226 | 59 |
samples of proven cases | 196 | 52 |
samples of probable cases | 30 | 7 |
serum samples of control patients | 154 | 41 |
suspected borreliosis | 78 | 21 |
control following HSCT | 76 | 20 |
n | % | |
---|---|---|
EORTC/MSG category | ||
proven IA | 47 | 87 |
by culture | 37 | 79 |
by histology only | 9 | 19 |
probable IA* | 7 | 13 |
focus of IA | ||
respiratory tract | 34 | 63 |
intraabdominal | 6 | 11 |
circulatory system | 5 | 9 |
central nervous system | 3 | 6 |
bones and joints | 2 | 4 |
urogenital tract | 2 | 4 |
orbita | 1 | 2 |
skin | 1 | 2 |
isolated species | ||
proven cause of infection | ||
A. fumigatus | 32 | 59 |
A. flavus | 3 | 6 |
A. niger | 1 | 2 |
cultivation only from non-sterile body site | ||
A. fumigatus | 7 | 13 |
n | % | |
---|---|---|
demographic characteristics | ||
all cases of IA | 54 | 100 |
female sex | 21 | 39 |
age | ||
mean | 56 | |
median | 60 | |
underlying conditions | ||
hematologic malignancy | 22 | 41 |
history of HSCT | 13 | 24 |
solid organ transplantation | 15 | 28 |
lung | 8 | 15 |
heart | 3 | 6 |
liver | 3 | 6 |
kidney | 1 | 2 |
intensive care treatment | 9 | 17 |
solid organ malignancy | 3 | 6 |
immunosuppressive therapy | 2 | 4 |
predisposition unclear | 2 | 4 |
cystic fibrosis (treated in ICU) | 1 | 2 |
GM | BDG | GM ∧ BDG | GM ∨ BDG | |
---|---|---|---|---|
sensitivity | ||||
sera closest to day 0 | 40% | 57% | 27% | 70% |
hematologic disease | 53% | 53% | 33% | 73% |
other underlying conditions | 34% | 59% | 25% | 69% |
focus: respiratory system | 33% | 52% | 22% | 63% |
focus: non-respiratory | 50% | 65% | 35% | 80% |
per case sensitivity | ||||
sera ± 7 days from day 0 | 47% | 68% | 34% | 81% |
hematologic disease | 60% | 67% | 40% | 87% |
other underlying conditions | 41% | 69% | 31% | 78% |
focus: respiratory system | 41% | 63% | 30% | 74% |
focus: non-respiratory | 55% | 75% | 40% | 90% |
sera – 6 to + 1 week from day 0 | 51% | 74% | 40% | 85% |
hematologic disease | 67% | 80% | 53% | 93% |
other underlying conditions | 44% | 72% | 34% | 81% |
focus: respiratory system | 41% | 70% | 33% | 78% |
focus: non-respiratory | 65% | 80% | 50% | 95% |
specificity | ||||
all control sera | 99% | 92% | 100% | 91% |
suspicion of borreliosis | 99% | 90% | 100% | 91% |
control following BMT | 100% | 93% | 100% | 91% |
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Dichtl, K.; Forster, J.; Ormanns, S.; Horns, H.; Suerbaum, S.; Seybold, U.; Wagener, J. Comparison of β-D-Glucan and Galactomannan in Serum for Detection of Invasive Aspergillosis: Retrospective Analysis with Focus on Early Diagnosis. J. Fungi 2020, 6, 253. https://doi.org/10.3390/jof6040253
Dichtl K, Forster J, Ormanns S, Horns H, Suerbaum S, Seybold U, Wagener J. Comparison of β-D-Glucan and Galactomannan in Serum for Detection of Invasive Aspergillosis: Retrospective Analysis with Focus on Early Diagnosis. Journal of Fungi. 2020; 6(4):253. https://doi.org/10.3390/jof6040253
Chicago/Turabian StyleDichtl, Karl, Johannes Forster, Steffen Ormanns, Heidi Horns, Sebastian Suerbaum, Ulrich Seybold, and Johannes Wagener. 2020. "Comparison of β-D-Glucan and Galactomannan in Serum for Detection of Invasive Aspergillosis: Retrospective Analysis with Focus on Early Diagnosis" Journal of Fungi 6, no. 4: 253. https://doi.org/10.3390/jof6040253