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SHR Neuro Cancer Cardio Lipid Metab Microb

Ghazanfari, M; Yazdani, Charati, J; Davoodi, L; Arastehfar, A; Moazeni, M; Abastabar, M; Haghani, I; Mayahi, S; Hoenigl, M; Pan, W; Hedayati, MT.
Comparative analysis of galactomannan lateral flow assay, galactomannan enzyme immunoassay and BAL culture for diagnosis of COVID-19-associated pulmonary aspergillosis.
Mycoses. 2022; 65(10):960-968 Doi: 10.1111/myc.13518 [OPEN ACCESS]
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Leading authors Med Uni Graz

Hönigl Martin

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Abstract:

BACKGROUND: Galactomannan Enzyme Immunoassay (GM-EIA) is proved to be a cornerstone in the diagnosis of COVID-19-associated pulmonary aspergillosis (CAPA), its use is limited in middle and low-income countries, where the application of simple and rapid test, including Galactomannan Lateral Flow Assay (GM-LFA), is highly appreciated. Despite such merits, limited studies directly compared GM-LFA with GM-EIA. Herein we compared the diagnostic features of GM-LFA, GM-EIA and bronchoalveolar lavage (BAL) culture for CAPA diagnosis in Iran, a developing country. MATERIALS/METHODS: Diagnostic performances of GM-LFA and GM-EIA in BAL (GM indexes ≥1) and serum (GM indexes >0.5), i.e. sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) and areas under the curve (AUC), were evaluated using BAL (n = 105) and serum (n = 101) samples from mechanically ventilated COVID-19 patients in intensive care units. Patients were classified based on the presence of host factors, radiological findings and mycological evidences according to 2020 ECMM/ISHAM consensus criteria for CAPA diagnosis. RESULTS: The Aspergillus GM-LFA for serum and BAL samples showed a sensitivity of 56.3% and 60.6%, specificity of 94.2% and 88.9%, PPV of 81.8% and 71.4%, NPV of 82.3% and 83.1%, when compared with BAL culture, respectively. GM-EIA showed sensitivities of 46.9% and 54.5%, specificities of 100% and 91.7%, PPVs of 100% and 75%, NPVs of 80.2% and 81.5% for serum and BAL samples, respectively. CONCLUSION: Our study found GM-LFA as a reliable simple and rapid diagnostic tool, which could circumvent the shortcomings of culture and GM-EIA and be pivotal in timely initiation of antifungal treatment.

Find related publications in this database (using NLM MeSH Indexing)

Antifungal Agents - administration & dosage

Bronchoalveolar Lavage Fluid - microbiology

COVID-19 - diagnosis

COVID-19 Testing - administration & dosage

Galactose - analogs & derivatives

Humans - administration & dosage

Immunoenzyme Techniques - administration & dosage

Invasive Pulmonary Aspergillosis - diagnosis, microbiology

Mannans - administration & dosage

Pulmonary Aspergillosis - administration & dosage

Sensitivity and Specificity - administration & dosage

Find related publications in this database (Keywords)

COVID-19-associated pulmonary aspergillosis

culture

galactomannan enzyme immunoassay

galactomannan lateral flow assay

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