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Diagn Microbiol Infect Dis. 2014 Sep;80(1):83-6. doi: 10.1016/j.diagmicrobio.2014.05.015. Epub 2014 May 21.

Predictors of mortality in non-neutropenic patients with invasive pulmonary aspergillosis: does galactomannan have a role?

Author information

1
Department of Public Health and Infectious Diseases, Policlinico Umberto I, "Sapienza" University of Rome, Italy.
2
Department of Clinical Medicine, Policlinico Umberto I, "Sapienza" University of Rome, Italy.
3
Department of Public Health and Infectious Diseases, Policlinico Umberto I, "Sapienza" University of Rome, Italy. Electronic address: mario.venditti@uniroma1.it.

Abstract

We aimed to investigate the role of several host factors as predictors of mortality in non-neutropenic patients with invasive pulmonary aspergillosis (IPA). Contribution of respiratory galactomannan (GM) index was evaluated as well. In this retrospective study, we examined 27 patients with "proven" and "probable" IPA. Outcome measured was death within 6-week from diagnosis of possible IPA. Overall mortality was 33.3%. At univariate analysis, nonsurvivors were statistically more likely to be affected with cirrhosis. No independent variables predicting mortality were identified in the multivariate model. Mean bronchoalveolar lavage (BAL) GM index value in the nonsurvivor group was significantly higher. A GM index cutoff value ≥ 2.0 is able to classify patients with a poor outcome with a sensitivity of 100% and a specificity of 77%. Liver cirrhosis is a predictor of mortality in patients with IPA. GM index in BAL might be considered as a valuable tool in classifying patients at risk of poor outcome.

KEYWORDS:

Bronchoalveolar lavage; Chronic obstructive pulmonary disease; Cirrhosis; Galactomannan; Invasive pulmonary aspergillosis

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