|
|
| Galactomannan Detection in CT-Based Broncho-Alveolar Lavage Fluid has a High Positive Predicting Value for Diagnosing Invasive Pulmonary Aspergillosis in Neutropenic Patients |
| Category:
D. Diagnostic Lab, Tests: Methods for Antibacterial Susceptibility Testing |
M. J. BECKER, E. J. LUGTENBURG, J. J. CORNELISSEN, C. VAN DER SCHEE, H. C. HOOGSTEDEN, S. DE MARIE;
Erasmus MC, Rotterdam, Netherlands. |
| Presentation Number: M-906 |
| Poster Board Number: 906 |
| Keyword:
aspergillosis, galactomannan, CT |
| Background: Invasive pulmonary aspergillosis (IPA) remains a major hazard in immonucompromised patients. Early diagnosis is of great importance, since it improves the outcome of the disease. We investigated the value of galactomannan (GM) detection in CT-based BAL- fluid and serum for the diagnosis of (IPA) in hematologic-oncologic patients. Methods: A prospective study in neutropenic patients was performed in two parts. CT of the thorax and BAL were performed systematically at pre-defined clinical indications. GM was determined by sandwich ELISA ("Platelia"). In the first part of the study GM was determined in serially sampled serum and CT-based BAL- fluid, clinicians being unaware of the results. In the second part of the study, GM detection in CT-based BAL-fluid was validated in an unblinded investigation. Results: In the first part of the study, 160 patients were included, of which 18 (10.6%) presented with proven, probable or suspected IPA. The sensitivity, specificity, positive predicting value (PPV) and negative predicting value (NPV) of GM detection in BAL-fluid were all 100% (criterion: at least one BAL-fluid per patient positive). For GM detection in serum (at least two consecutive samples positive) the sensitivity was 47%, the specificity 93%, the PPV 73% and the NPV 82%. In the second part of the study 22 of 198 patients (11.1%) presented with IPA and the sensitivity was 85%, specificity and PPV were 100% and the NPV was 88%. None of BAL-fluids obtained during antifungal treatment of 3 days or more were positive. Conclusion: When CT is used systematically and early, GM detection in CT-based BAL-fluid has a high PPV for diagnosing IPA early in untreated patients. GM detection in serum is of less value in this setting. |
| Commercial Relationship: M.J. Becker, None. |
| PresentationPref: Slide |
| NoOffLabel: True |
| |
|
|
|
|
|
|
The Online Abstract Submission and Invitation System
© 1996 - 2010 Coe-Truman Technologies, Inc. All rights reserved.
|
|
|
|
|
|
