GALACTOMANNAN ANTIGEN TEST IN RESPIRATORY SAMPLES FOR ASPERGILLOSIS DIAGNOSIS

Abstract

Introduction: Invasive aspergillosis is an important cause of mortality in patients with malignant diseases, and is an underestimated infection in critically ill patients. Early diagnosis is still challenging, therefore a rapid and more sensitive diagnostic methods could be beneficial. 

Aim: the aim of the study was to evaluate the sensitivity and specificity of the galactomannan antigen test in respiratory samples, compared to conventional methods, for early diagnosis of aspergillosis. 

Material and methods: Samples of 125 patients divided into 4 groups, classified according to diagnosis and EORTC/MSG criteria, were analysed at the Institute of Microbiology and Parasitology, with culture and galactomannan test in respiratory samples, during a period of two years. 

Results: A total of 71 isolates of Aspergillus were confirmed in this study. Culture of respiratory samples revealed Aspergillus in the group of chronic aspergillosis (63.33%), followed by groups of cystic fibrosis (56.67%), primary immune deficiency (51.43%), and the group with prolonged ICU stay (43.33%). Sensitivity and specificity of respiratory samples’ culture were: 64.29% and 100%, 59.09% and 100%, 54.55% and 12.5%, 100% and 54.17%, in all four groups, respectively. Sensitivity and specificity of galactomannan in respiratory samples, were: 75% and 57.14%, 86.36% and 62.5%, 81.82% and 0%, 50% and 70.83%, in all 4 groups, respectively.  

Conclusion: The results of this study demonstrate that positive galactomannan test in respiratory samples could be a useful diagnostic adjunct in diagnosis of aspergillosis, along with results from conventional mycological analyses, so timely antifungal treatment is administered.