Aspergillus galactomannan detection in exhaled breath condensate compared to bronchoalveolar lavage fluid for the diagnosis of invasive aspergillosis in immunocompromised patients

被引：21

作者：

Bhimji, A. ^{[1
,2
]}

Bhaskaran, A. ^{[2
]}

Singer, L. G. ^{[3
,4
]}

Kumar, D. ^{[2
,4
]}

Humar, A. ^{[2
,4
]}

Pavan, R. ^{[2
]}

Lipton, J. ^{[4
,5
,6
]}

Kuruvilla, J. ^{[4
,5
,6
]}

Schuh, A. ^{[4
,5
,6
]}

Yee, K. ^{[4
,5
,6
]}

Minden, M. D. ^{[4
,5
,6
]}

Schimmer, A. ^{[4
,5
,6
]}

Rotstein, C. ^{[2
,4
]}

Keshavjee, S. ^{[2
,3
,4
]}

Mazzulli, T. ^{[1
,7
]}

Husain, S. ^{[2
,4
]}

机构：

[1] Univ Toronto, Dept Lab Med & Pathobiol, Toronto, ON, Canada

[2] Univ Hlth Network, Multiorgan Transplant Program, Transplant Infect Dis, Toronto, ON, Canada

[3] Univ Hlth Network, Toronto Lung Transplant Program, Toronto, ON, Canada

[4] Univ Hlth Network, Dept Med, Toronto, ON, Canada

[5] Univ Hlth Network, Mt Sinai Hosp, Princess Margaret Canc Ctr, Toronto, ON, Canada

[6] Univ Hlth Network, Mt Sinai Hosp, Div Med Oncol & Hematol, Toronto, ON, Canada

[7] Mt Sinai Hosp, Dept Microbiol, 600 Univ Ave,Room 1487, Toronto, ON M5G 1X5, Canada

来源：

CLINICAL MICROBIOLOGY AND INFECTION | 2018年 / 24卷 / 06期

关键词：

Bronchoalveolar lavage; ELISA; Exhaled breath condensate; Fungal diagnostics; Galactomannan; Invasive aspergillosis; Noninvasive sampling; ORGAN TRANSPLANT RECIPIENTS; FUNGAL-INFECTIONS; DISEASE; SERUM; REPRODUCIBILITY; EPIDEMIOLOGY; SURVEILLANCE; DEFINITIONS; STORAGE;

D O I：

10.1016/j.cmi.2017.09.018

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Objectives: Exhaled breath condensate (EBC) is a noninvasive means of sampling the airways that has shown significant promise in the diagnosis of many disorders. There have been no reports of its usefulness in the detection of galactomannan (GM), a component of the cell wall of Aspergillus. The suitability of EBC for the detection of GM for the diagnosis of invasive aspergillosis (IA) using the Platelia Aspergillus enzyme-linked immunosorbent assay was investigated. Methods: Prospective, cross-sectional study of lung transplant recipient and haemotologic malignancy patients at a university centre. EBC samples were compared to concomitant bronchoalveolar lavage (BAL) samples among lung transplant recipients and healthy controls. EBC was collected over 10 minutes using a refrigerated condenser according to the European Respiratory Society/American Thoracic Society recommendations, with the BAL performed immediately thereafter. Results: A total of 476 EBC specimens with 444 matched BAL specimens collected from lung transplant recipients (n - 197) or haemotologic malignancy patients (n - 133) were examined. Both diluted and untreated EBC optical density (OD) values (0.0830, interquartile range (IQR) 0.0680-0.1040; and 0.1130, IQR 0.0940-0.1383), respectively, from all patients regardless of clinical syndrome were significantly higher than OD values in healthy control EBCs (0.0508, IQR 0.0597-0.0652; p < 0.0001). However, the OD index values did not correlate with the diagnosis of IA (44 samples were associated with IA). Furthermore, no significant correlation was found between EBC GM and the matched BAL specimen. Conclusions: GM is detectable in EBC; however, no correlation between OD index values and IA was noted in lung transplant recipients. (C) 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

引用

页码：640 / 645

页数：6

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