The diagnostic value of the glactomannan and (1, 3)- beta-D-glucan in diagnosis of invasive aspergillosis İnvazi̇v aspergi̇llozun tanisinda (1,3)-beta-D glukan ve galaktomannanin tanisal deǧeri̇


Hörmet Ö. H., Koç A. N., Atalay M. A., Eser B., Yıldız O., Kaynar L.

Nobel Medicus, vol.10, no.2, pp.44-49, 2014 (SCI-Expanded) identifier

  • Publication Type: Article / Article
  • Volume: 10 Issue: 2
  • Publication Date: 2014
  • Journal Name: Nobel Medicus
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.44-49
  • Keywords: (1,3)-β-D-glucan, Aspergillus, Galactomannan, Invasive aspergillosis
  • Istanbul Medipol University Affiliated: No

Abstract

Objective: Invasive aspergillosis (IA) is associated with an unacceptably high mortality rate. Early diagnosis is critical to a favourable outcome, but it is difficult to achieve with conventional methods. For these reasons, a range of alternate diagnostic strategies have been investigated. It was aimed to evaluate the diagnostic potential of the galactomannan (GM), 1, 3 beta-D-glucan (BDG) for IA. Material and Methods: Various clinical specimens of the 87 patients with suspected IA infections and 30 control patients in Erciyes University Gevher Nesibe Hospitals clinics were included in this study. Culture and direct microscope of clinical specimens were performed. Aspergillus antigen was investigated in sera specimens by enzyme-linked immunosorbent assay (ELISA) for GM (Platelia Aspergillus, BioRad, France) and an assay for BDG (Fungitell; Associates of Cape Cod). Results: A total of 87 patients 57 patients with IA and 30 control patients were included in this study and of the 57 patients 3 had proven IA cases, 33 probable IA cases and 21 possible invasive fungal infections. Fifty-seven patients had proven, probable and possible IA that were positive in 68% for BDG assay and in 38% for GM assay. The use of a combination of the BDG and the GM assay increased the sensitivity to 71.9%, decreased the specificity to 91%. Cultures of 16 patients was isolated in Aspergillus species (13 A. fumigatus, A. favus, and one of two A. niger. Diagnostic performance of GM test at different cutoff values and BDG test, respectively for cultures of 16 patients were in 68% for the GM test (cut off ≥0.5) in 93%, 62% for BDG test (cut off ≥80 pg/ml) (single and consecutively example). Conclusion: Among these screening tests for IA, BDG test was the most sensitive at predicting the diagnosis of IA in high-risk patients and a combination of two tests would improve the diagnosis of IA. Therefore, the diagnosis of IA should be considered by the use of both tests.