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Local retrospective analysis of galactomannan cut-off values in bronchoalveolar lavage fluids for diagnosis of invasive aspergillosis

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Abstract

Galactomannan antigen (GM) testing has been used for decades to screen immunocompromised patients for invasive aspergillosis (IA). Recent publications suggested that using a higher cut-off value than 0.5 in bronchoalveolar lavage fluid (BALF) could be more discriminant for hematology patients. We retrospectively analyzed the values of GM in BALF over 7 years (from 2010 to 2016). Performance indicators of the GM in BALF, according to three different cut-off values (0.5, 0.8, 1.5), were calculated using Stata 14.1. IA classification for hematology patients was based on European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) criteria, as defined in 2008. A number of 716 GM were performed on BALF from 2010 to 2016 (597 patients) and 66 were positive (> 0.5). Among these 597 patients, 27 IA were diagnosed, 13 with a positive GM in BALF, 9 with a negative GM in BALF, and 5 unclassified IA (ICU patients). The analysis of performance indicators, based on our local data, did not demonstrate any significant difference using a higher cut-off value of GM in BALF. This result may be explained by the local recruitment of patients and by pre-analytic variations during BALF realization.

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References

  • Alanio A, Bretagne S (2017) Challenges in microbiological diagnosis of invasive Aspergillus infections. F1000Res 6

  • Bellanger AP, Millon L, Berceanu A, Grenouillet F, Grenouillet FE, Larosa F, Deconinck E (2015) Combining Aspergillus mitochondrial and ribosomal QPCR, in addition to galactomannan assay, for early diagnosis of invasive aspergillosis in hematology patients. Med Mycol 53:760–764

    Article  CAS  PubMed  Google Scholar 

  • Bergeron A, Porcher R, Menotti J, Poirot JL, Chagnon K, Vekhoff A, Cornet M, Isnard F, Raffoux E, Brethon B, Lacroix C, Touratier S, Latgé JP, Bouges-Michel C, Tazi A, Derouin F, Ribaud P, Sulahian A (2012) Prospective evaluation of clinical and biological markers to predict the outcome of invasive pulmonary aspergillosis in hematological patients. J Clin Microbiol 50:823–830

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Bustin SA, Benes V, Garson JA, Hellemans J, Huggett J, Kubista M, Mueller R, Nolan T, Pfaffl MW, Shipley GL, Vandesompele J, Wittwer CT (2009) The MIQE guidelines: minimum information for publication of quantitative real-time PCR experiments. Clin Chem 55:611–622

    Article  CAS  PubMed  Google Scholar 

  • De Pauw B, Walsh TJ, Donnelly JP, Stevens DA, Edwards JE, Calandra T, Pappas PG, Maertens J, Lortholary O, Kauffman CA, Denning DW, Patterson TF, Maschmeyer G, Bille J, Dismukes WE, Herbrecht R, Hope WW, Kibbler CC, Kullberg BJ, Marr KA, Muñoz P, Odds FC, Perfect JR, Restrepo A, Ruhnke M, Segal BH, Sobel JD, Sorrell TC, Viscoli C, Wingard JR, Zaoutis T, Bennett JE (2008) Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. Clin Infect Dis 46:1813–1821

    Article  PubMed  PubMed Central  Google Scholar 

  • Fortún J, Martín-Dávila P, Gomez Garcia de la Pedrosa E, Silva JT, Garcia-Rodríguez J, Benito D, Venanzi E, Castaño F, Fernández-Ruiz M, Lazaro F, García-Luján R, Quiles I, Cabanillas JJ, Moreno S, Aguado JM (2016) Galactomannan in bronchoalveolar lavage fluid for diagnosis of invasive aspergillosis in non-hematological patients. J Infect 72:738–744

    Article  PubMed  Google Scholar 

  • Heng SC, Chen SC, Morrissey CO, Thursky K, Manser RL, De Silva HD, Halliday CL, Seymour JF, Nation RL, Kong DC, Slavin MA (2014) Clinical utility of Aspergillus galactomannan and PCR in bronchoalveolar lavage fluid for the diagnosis of invasive pulmonary aspergillosis in patients with haematological malignancies. Diagn Microbiol Infect Dis 79:322–327

    Article  CAS  PubMed  Google Scholar 

  • Heng SC, Morrissey O, Chen SC, Thursky K, Manser RL, Nation RL, Kong DC, Slavin M (2015) Utility of bronchoalveolar lavage fluid galactomannan alone or in combination with PCR for the diagnosis of invasive aspergillosis in adult hematology patients: a systematic review and meta-analysis. Crit Rev Microbiol 41:124–134

    Article  CAS  PubMed  Google Scholar 

  • Millon L, Piarroux R, Deconinck E, Bulabois CE, Grenouillet F, Rohrlich P, Costa JM, Bretagne S (2005) Use of real-time PCR to process the first galactomannan-positive serum sample in diagnosing invasive aspergillosis. J Clin Microbiol 43:5097–5101

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Schroeder M, Simon M, Katchanov J, Wijaya C, Rohde H, Christner M, Laqmani A, Wichmann D, Fuhrmann V, Kluge S (2016) Does galactomannan testing increase diagnostic accuracy for IPA in the ICU? A prospective observational study. Crit Care 20:139

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

We thank Pamela Albert for her editorial assistance. No specific funding was received for the present study.

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Correspondence to Anne-Pauline Bellanger.

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Bellanger, AP., Gbaguidi-Haore, H., Tatoyan, N. et al. Local retrospective analysis of galactomannan cut-off values in bronchoalveolar lavage fluids for diagnosis of invasive aspergillosis. Folia Microbiol 63, 757–761 (2018). https://doi.org/10.1007/s12223-018-0618-z

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  • DOI: https://doi.org/10.1007/s12223-018-0618-z

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