The clinical value of Aspergillus-specific IgG antibody test in the diagnosis of nonneutropenic invasive pulmonary aspergillosis

被引:13
作者
Lu, Yajie [1 ,2 ]
Liu, Lulu [2 ]
Li, Hongxing [3 ]
Chen, Bilin [2 ]
Gu, Yu [4 ]
Wang, Li [5 ]
Feng, Chunlai [6 ]
Chen, Cheng [7 ]
Chen, Yanbin [7 ]
Sun, Wenkui [8 ]
Cui, Xuefan [8 ]
Cao, Min [1 ]
Tao, Yujian [9 ]
Zhong, Jinjin [2 ]
Zhong, Huanhuan [2 ]
Ni, Yueyan [4 ]
Cai, Yuchen [2 ]
Song, Mengyue [4 ]
Liu, Xiaoguang [3 ]
Shi, Yi [2 ]
Su, Xin [1 ,2 ,3 ,4 ]
机构
[1] Nanjing Univ, Nanjing Drum Tower Hosp, Dept Resp & Crit Care Med, Affiliated Hosp,Med Sch, 2 Jinling Hosp, Nanjing 210002, Peoples R China
[2] Nanjing Univ, Jinling Hosp, Dept Resp & Crit Care Med, Med Sch, Nanjing, Peoples R China
[3] Nanjing 2 Southern Med Univ, Jinling Hosp, Dept Resp & Crit Care Med, Guangzhou, Peoples R China
[4] Nanjing Med Univ, Jinling Hosp, Dept Resp & Crit Care Med, Nanjing, Peoples R China
[5] Nanjing First Hosp, Dept Resp & Crit Care Med, Nanjing, Peoples R China
[6] Changzhou First Peoples Hosp, Dept Resp & Crit Care Med, Changzhou, Peoples R China
[7] Soochow Univ, Dept Resp & Crit Care Med, Affiliated Hosp 1, Suzhou, Peoples R China
[8] Nanjing Med Univ, Jiangsu Prov Hosp, Dept Resp & Crit Care Med, Affiliated Hosp 1, Nanjing, Peoples R China
[9] Yangzhou Univ, Dept Resp & Crit Care Med, Affiliated Hosp, Yangzhou, Peoples R China
基金
中国国家自然科学基金;
关键词
Aspergillus-specific IgG antibody; Diagnosis; Invasive pulmonary aspergillosis; Nonneutropenic patients; Plasma; ANTIGEN TEST; FUMIGATUS;
D O I
10.1016/j.cmi.2023.02.002
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Objectives: Aspergillus-specific IgG antibody ( Asp IgG) has been successfully applied in the diagnosis of chronic pulmonary aspergillosis. We explored its value in nonneutropenic invasive pulmonary aspergillosis (IPA) by a multicenter, prospective, and controlled study. Methods: We enrolled 372 clinically suspected nonneutropenic patients with IPA from February 2015 to August 2022. After excluding 4 cases with Aspergillus colonization, the remaining 368 cases were finally confirmed as patients with IPA (n =99), or non-IPA patients (n =269) consisting of community-acquired pneumonia (n =206), tuberculosis (n =22), nontuberculous mycobacteria (n =5), lung abscess (n =6), or noninfectious diseases (n =30). Asp IgG in plasma samples was tested by enzyme-linked immunosorbent assay. Results: At cut-off value of >= 80 AU/mL, Asp IgG had much higher sensitivity (59.6% vs. 19.2%, p < 0.0001), but lower specificity (77.0% vs. 96.3%, p < 0.0001) than serum galactomannan (GM) (cut-off value of >= 1.0), and similar sensitivity (59.6% vs. 55.6%, p =0.611) but lower specificity (77.0% vs. 91.2%, p =0.001) than bronchoalveolar lavage fluid (BALF) GM (cut-off value of >= 1.0), respectively. Combination diagnosis of either positive for Asp IgG or BALF GM had higher sensitivity (81.0% vs. 55.6%, p =0.002), but lower specificity ( 75.2% vs. 91.2%, p =0.001) than BALF GM alone. The receiver operating characteristic curve showed that Asp IgG had an optimal diagnostic value when the cut-off value was 56.6 AU/ml, and the sensitivity and specificity were 77.8% and 63.9%, respectively. Discussions: The diagnostic value of Asp IgG for IPA is superior to serum GM, and a little inferior to BALF GM in nonneutropenic patients with IPA. Considering the convenience of taking blood samples, it is a good screening and diagnostic method for nonneutropenic patients with IPA, especially for those who cannot bear invasive procedures. (C) 2023 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:797e1 / 797e7
页数:7
相关论文
共 50 条
[41]   Role of Aspergillus Specific IgG Titres as a Therapeutic Target for Chronic Pulmonary Aspergillosis: A Longitudinal Study [J].
Agarwal, Kshitij ;
Bhati, Gaurav ;
Gupta, Prateek ;
Verma, Amit Kumar .
JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2023, 17 (02) :OC01-OC04
[42]   Optimising the cut-off of the Bordier Aspergillus IgG ELISA for the diagnosis of chronic pulmonary aspergillosis [J].
Wilopo, Bayu A. P. ;
Hunter, Elizabeth Stucky ;
Richardson, Malcolm D. ;
Denning, David W. .
JOURNAL OF MICROBIOLOGICAL METHODS, 2020, 176
[43]   USE OF THE PASTOREX ASPERGILLUS ANTIGEN LATEX AGGLUTINATION-TEST FOR THE DIAGNOSIS OF INVASIVE ASPERGILLOSIS [J].
HOPWOOD, V ;
JOHNSON, EM ;
CORNISH, JM ;
FOOT, ABM ;
EVANS, EGV ;
WARNOCK, DW .
JOURNAL OF CLINICAL PATHOLOGY, 1995, 48 (03) :210-213
[44]   Serological Changes in Anti-Aspergillus IgG Antibody and Development of Chronic Pulmonary Aspergillosis in Patients Treated for Pulmonary Tuberculosis [J].
Kim, Changwhan ;
Moon, Jin-Wook ;
Park, Yong-Bum ;
Ko, Yousang .
JOURNAL OF FUNGI, 2022, 8 (02)
[45]   Clinical utility of Aspergillus galactomannan and PCR in bronchoalveolar lavage fluid for the diagnosis of invasive pulmonary aspergillosis in patients with haematological malignancies [J].
Heng, Siow-Chin ;
Chen, Sharon C. -A. ;
Morrissey, C. Orla ;
Thursky, Karin ;
Manser, Renee L. ;
De Silva, Harini D. ;
Halliday, Catriona L. ;
Seymour, John F. ;
Nation, Roger L. ;
Kong, David C. M. ;
Slavin, Monica A. .
DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE, 2014, 79 (03) :322-327
[46]   Diagnosis of invasive pulmonary aspergillosis: Value of bronchoalveolar lavage galactomannan for immunocompromised patients [J].
Paugam, A. ;
Baixench, M. -T. ;
Lebuisson, A. ;
Dupouy-Camet, J. .
PATHOLOGIE BIOLOGIE, 2010, 58 (01) :100-103
[47]   Prospective Evaluation of a New Aspergillus IgG Enzyme Immunoassay Kit for Diagnosis of Chronic and Allergic Pulmonary Aspergillosis [J].
Dumollard, C. ;
Bailly, S. ;
Perriot, S. ;
Brenier-Pinchart, M. P. ;
Saint-Raymond, C. ;
Camara, B. ;
Gangneux, J. P. ;
Persat, F. ;
Valot, S. ;
Grenouillet, F. ;
Pelloux, H. ;
Pinel, C. ;
Cornet, M. .
JOURNAL OF CLINICAL MICROBIOLOGY, 2016, 54 (05) :1236-1242
[48]   Assessment of Aspergillus-specific PCR as a screening method for invasive aspergillosis in paediatric cancer patients and allogeneic haematopoietic stem cell recipients with suspected infections [J].
Reinwald, M. ;
Konietzka, C. A. M. ;
Kolve, H. ;
Uhlenbrock, S. ;
Ahlke, E. ;
Hummel, M. ;
Spiess, B. ;
Hofmann, W-K ;
Buchheidt, D. ;
Groll, A. H. .
MYCOSES, 2014, 57 (09) :537-543
[49]   Performance of Aspergillus Galactomannan Lateral Flow Assay on Bronchoalveolar Lavage Fluid for the Diagnosis of Invasive Pulmonary Aspergillosis [J].
Linder, Kathleen A. ;
Kauffman, Carol A. ;
Miceli, Marisa H. .
JOURNAL OF FUNGI, 2020, 6 (04) :1-9
[50]   Evaluation of Aspergillus IgG, IgM antibody for diagnosing in chronic pulmonary aspergillosis A prospective study from a single center in China [J].
Guo, Yiqun ;
Bai, Yu ;
Yang, Chunxia ;
Gu, Li .
MEDICINE, 2019, 98 (16)