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Folia Microbiol (Praha). 2018 Nov;63(6):757-761. doi: 10.1007/s12223-018-0618-z. Epub 2018 May 30.

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

Author information

1
Department of Parasitology-Mycology, Besançon University Hospital, Besançon, France. apbellanger@chu-besancon.fr.
2
Chrono-Environnement CNRS 6249 Research Team, Franche-Comté University, Besançon, France. apbellanger@chu-besancon.fr.
3
Infection Control Department, Besançon University Hospital, Besançon, France.
4
Department of Parasitology-Mycology, Besançon University Hospital, Besançon, France.
5
Intensive Care Hematology Unit, Besançon University Hospital, Besançon, France.
6
Chrono-Environnement CNRS 6249 Research Team, Franche-Comté University, Besançon, France.

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.

PMID:
29846912
DOI:
10.1007/s12223-018-0618-z
[Indexed for MEDLINE]

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