Clinical utility and prognostic value of bronchoalveolar lavage galactomannan in patients with hematologic malignancies

被引：47

作者：

Luong, Me-Linh ^{[1
,2
]}

Filion, Charles ^{[1
]}

Labbe, Annie-Claude ^{[1
]}

Roy, Jean ^{[3
]}

Pepin, Jacques ^{[4
]}

Cadrin-Tourigny, Julia ^{[1
]}

Carignan, Stephane ^{[5
]}

Sheppard, Donald C. ^{[2
]}

Laverdiere, Michel ^{[1
]}

机构：

[1] Univ Montreal, Hop Maison Neuve Rosemont, Dept Microbiol, Montreal, PQ H1T 2M4, Canada

[2] McGill Univ, Ctr Hlth, Dept Microbiol, Montreal, PQ H3A 2B4, Canada

[3] Univ Montreal, Hop Maison Neuve Rosemont, Dept Med, Div Hematooncol, Montreal, PQ H1T 2M4, Canada

[4] Univ Sherbrooke, Dept Microbiol & Infect Dis, Sherbrooke, PQ J1H 5N4, Canada

[5] Univ Montreal, Hop Maison Neuve Rosemont, Dept Radiol, Montreal, PQ H1T 2M4, Canada

来源：

DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE | 2010年 / 68卷 / 02期

关键词：

Aspergillosis; Galactomannan; Bronchoalveolar lavage; Hematologic malignancies; INVASIVE PULMONARY ASPERGILLOSIS; CELL TRANSPLANT RECIPIENTS; ENZYME-IMMUNOASSAY; FUNGAL-INFECTIONS; ANTIGEN-DETECTION; MOLD INFECTIONS; DIAGNOSIS; FLUID; SERUM; ASSAY;

D O I：

10.1016/j.diagmicrobio.2010.03.017

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

We conducted a single-center retrospective cohort study to determine the performance characteristics of the galactomannan (GM) assay in bronchoalveolar lavage (BAL) in patients with hematologic malignancies. Patients were classified as proven, probable, possible, or no invasive pulmonary aspergillosis (IPA), according to international guidelines. A total of 173 BAL samples from 145 patients were included. There were 5 proven, 7 probable, and 35 possible cases of IPA. Using a GM index cutoff of >= 0.5, the sensitivity, specificity, and positive and negative predictive values (PPV and NPV, respectively) of the BAL GM assay were 100%, 78%, 26%, and 100%, respectively. Using a GM index cutoff of >= 2.0, sensitivity and NPV remained 100%, but specificity and PPV increased to 93% and 50%, respectively. The BAL GM assay is a highly sensitive screening test for IPA in patients with hematologic malignancies. Increasing the cutoff value to 2.0 would improve the performance of this assay. (C) 2010 Elsevier Inc. All rights reserved.

引用

页码：132 / 139

页数：8

共 27 条

[1] Detection of Aspergillus galactomannan antigenemia to determine biological and clinical implications of beta-lactam treatments [J].

Bart-Delabesse, E ;

Basile, M ;

Al Jijakli, A ;

Souville, D ;

Gay, F ;

Philippe, B ;

Bossi, P ;

Danis, M ;

Vernant, JP ;

Datry, A .

JOURNAL OF CLINICAL MICROBIOLOGY, 2005, 43 (10) :5214-5220

[2] Galactomannan detection in computerized tomography-based broncho-alveolar lavage fluid and serum in haematological patients at risk for invasive pulmonary aspergillosis [J].

Becker, MJ ;

Lugtenburg, EJ ;

Cornelissen, JJ ;

van der Schee, C ;

Hoogsteden, HC ;

de Marie, S .

BRITISH JOURNAL OF HAEMATOLOGY, 2003, 121 (03) :448-457

[3] Aspergillus in the lung:: diverse and coincident forms [J].

Buckingham, SJ ;

Hansell, DM .

EUROPEAN RADIOLOGY, 2003, 13 (08) :1786-1800

[4] Bronchoalveolar lavage galactomannan in diagnosis of invasive pulmonary aspergillosis among solid-organ transplant recipients [J].

Clancy, Cornelius J. ;

Jaber, Reia A. ;

Leather, Helen L. ;

Wingard, John R. ;

Staley, Benjamin ;

Wheat, L. Joseph ;

Cline, Christina L. ;

Rand, Kenneth H. ;

Schain, Denise ;

Baz, Maher ;

Nguyen, M. Hong .

JOURNAL OF CLINICAL MICROBIOLOGY, 2007, 45 (06) :1759-1765

[5] Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group [J].

De Pauw, Ben ;

Walsh, Thomas J. ;

Donnelly, J. Peter ;

Stevens, David A. ;

Edwards, John E. ;

Calandra, Thierry ;

Pappas, Peter G. ;

Maertens, Johan ;

Lortholary, Olivier ;

Kauffman, Carol A. ;

Denning, David W. ;

Patterson, Thomas F. ;

Maschmeyer, Georg ;

Bille, Jacques ;

Dismukes, William E. ;

Herbrecht, Raoul ;

Hope, William W. ;

Kibbler, Christopher C. ;

Kullberg, Bart Jan ;

Marr, Kieren A. ;

Munoz, Patricia ;

Odds, Frank C. ;

Perfect, John R. ;

Restrepo, Angela ;

Ruhnke, Markus ;

Segal, Brahm H. ;

Sobel, Jack D. ;

Sorrell, Tania C. ;

Viscoli, Claudio ;

Wingard, John R. ;

Zaoutis, Theoklis ;

Bennett, John E. .

CLINICAL INFECTIOUS DISEASES, 2008, 46 (12) :1813-1821

[6] Guidelines for the investigation of invasive fungal infections in haematological malignancy and solid organ transplantation [J].

Denning, DW ;

Evans, EGV ;

Kibbler, CC ;

Richardson, MD ;

Roberts, MM ;

Rogers, TR ;

Warnock, DW ;

Warren, RE .

EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES, 1997, 16 (06) :424-436

[7] Risks and outcomes of invasive fungal infections in recipients of allogeneic hematopoietic stem cell transplants after nonmyeloablative conditioning [J].

Fukuda, T ;

Boeckh, M ;

Carter, RA ;

Sandmaier, BM ;

Maris, MB ;

Maloney, DG ;

Martin, PJ ;

Storb, RF ;

Marr, KA .

BLOOD, 2003, 102 (03) :827-833

[8] Epidemiology of invasive mold infections in allogeneic stem cell transplant recipients: Biological risk factors for infection according to time after transplantation [J].

Garcia-Vidal, Carol ;

Upton, Arlo ;

Kirby, Katharine A. ;

Marr, Kieren A. .

CLINICAL INFECTIOUS DISEASES, 2008, 47 (08) :1041-1050

[9] Aspergillus galactomannan detection in the diagnosis of invasive aspergillosis in cancer patients [J].

Herbrecht, R ;

Letscher-Bru, V ;

Oprea, C ;

Lioure, B ;

Waller, J ;

Campos, F ;

Villard, O ;

Liu, KL ;

Natarajan-Amé, S ;

Lutz, P ;

Dufour, P ;

Bergerat, JP ;

Candolfi, E .

JOURNAL OF CLINICAL ONCOLOGY, 2002, 20 (07) :1898-1906

[10] Aspergillus galactomannan antigen in the bronchoalveolar lavage fluid for the diagnosis of invasive aspergillosis in lung transplant recipients [J].

Husain, Shahid ;

Paterson, David L. ;

Studer, Sean M. ;

Crespo, Maria ;

Pilewski, Joseph ;

Durkin, Michelle ;

Wheat, Joseph L. ;

Johnson, Bruce ;

McLaughlin, Lisa ;

Bentsen, Christopher ;

McCuny, Kenneth R. ;

Singh, Nina .

TRANSPLANTATION, 2007, 83 (10) :1330-1336

← 1 2 3 →