COMPARISON OF DIAGNOSTIC VALUES OF SERUM PCR AND SERUM GALACTOMANNAN ANTIGEN ASSAY FOR DIAGNOSIS OF ASPERGILLOSIS

Abstract

Introduction: Aspergillosis is a major threat to immunocompromised hosts, but also to immunocompetent patients. Early diagnosis remains a diagnostic challenge, and there is a need for rapid and sensitive diagnostic methods. 

Aim: The aim of the study was to compare the diagnostic value of serum PCR assay with serum galactomannan antigen test, in the diagnosis of both invasive and non-invasive aspergillosis. 

Material and methods: During a period of two years (2014 – 2016), sera from 125 patients divided into 4 groups (group I-immune deficiency, group II-prolonged stay in ICU, group III-chronic aspergillosis, group IV-cystic fibrosis), classified according to clinical diagnosis and EORTC/MSG criteria, were analysed at the Institute of Microbiology and Parasitology, Faculty of Medicine Skopje, with molecular (PCR) and serological methods (galactomannan.

Results: PCR in serum demonstrated the following sensitivity and specificity: 53.57% and 100% in group I, 36.36% and 100% in group II, 9.09% and 100% in group III, respectively. Serum PCR was not performed in the cystic fibrosis group. The sensitivity and specificity of galactomannan in serum were 64.29% and 57.14%, 40.91% and 62.5%, and 40.91% and 62.5% in groups I, II, and III, respectively. 

Conclusion: Our results indicate that both PCR and galactomannan in serum could be useful adjunct tests for the diagnosis of both invasive and non-invasive aspergillosis, so an early antifungal treatment is initiated in order to achieve a more favorable clinical outcome.