Diagnostic value of serum galactomannan, (1,3)‐β‐d‐glucan, and Aspergillus fumigatus‐specific IgA and IgG assays for invasive pulmonary aspergillosis in non‐neutropenic patients

Dobias, R.; Jaworska, P.; Tomaskova, H.; Kanova, M.; Lyskova, P.; Vrba, Z.; Holub, C.; Svobodová, L.; Hamal, P.; Raska, M.

doi:10.1111/myc.12765

Cited by 42Antifungal resistance and susceptibilityFungal Infections and StudiesImmunodeficiency and Autoimmune Disorders

Diagnostic value of serum galactomannan, (1,3)‐β‐d‐glucan, and Aspergillus fumigatus‐specific IgA and IgG assays for invasive pulmonary aspergillosis in non‐neutropenic patients

Dobias, R., Jaworska, P., Tomaskova, H., Kanova, M., Lyskova, P., Vrba, Z., Holub, C., Svobodová, L. +2 more·2018·Mycoses

DOI 10.1111/myc.12765

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Abstract

Summary: Detection of serum galactomannan (GM) and (1,3)‐β‐d‐glucan (BG) is considered useful for non‐culture diagnosis of invasive pulmonary aspergillosis (IPA) in neutropenic patients. Only few studies evaluated these seromarkers in non‐neutropenic patients suspected of having IPA. The aim of this study was to evaluate both tests together with the Aspergillus fumigatus‐specific serum IgG and IgA (Ig AG) test for serological IPA diagnosis in non‐neutropenic patients. Sera from 87 patients suspected of having IPA were retrospectively analysed. Patients were categorised into groups of proven IPA (n = 10), putative IPA (n = 31) and non‐IPA colonisation (n = 46). When the GM, BG and Ig AG assays were used for patients included in the study, the sensitivity/specificity/positive predictive value (PPV)/negative predictive value (NPV) were 48.8%/91.3%/83.3%/66.7%, 82.9%/73.9%/73.9%/82.9% and 75.6%/95.7%/93.9%/81.5%, respectively. Thus, the highest specificity and PPV were confirmed for the Ig AG assay. Improvements in the sensitivity and NPV were achieved by “at least one positive” analysis with the GM and BG assays, with the sensitivity/specificity/PPV/NPV values being 85.0%/69.6%/71.4%/84.2%. Nevertheless, the highest sensitivity and NPV were achieved by the “at least one positive” analysis combining the GM, BG and Ig AG tests (97.6% and 96.8%, respectively). The involvement of the Ig AG assay could improve IPA diagnosis in non‐neutropenic patients by increasing the sensitivity and NPV when combined with the GM or BG assays. Furthermore, improvement was achieved by combining the GM, BG and Ig AG assays using the “at least one positive test” strategy, especially if doubt exists.

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Recent studies showed that BAL fluid GM has improved sensitivity compared to serum GM in high-risk patients with IPA, including nonneutropenic patients.
“Recent studies showed that BAL fluid GM has improved sensitivity compared to serum GM in high-risk patients with IPA, including nonneutropenic patients (88, 114–119).”
From Aspergillus fumigatus and Aspergillosis in 2019 (2019) · cites this paper as [118]

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Authors: Dobias, R., Jaworska, P., Tomaskova, H., Kanova, M., Lyskova, P., Vrba, Z., Holub, C., Svobodová, L., Hamal, P., & Raska, M.
Affiliations: Laboratory of Clinical Mycology, Bacteriology and Mycology Institute of Public Health in Ostrava Ostrava Czech Republic
Department of Microbiology Faculty of Medicine and Dentistry Palacky University Olomouc Olomouc Czech Republic
University of Ostrava (CZ)
Lung Department Krnov Combined Medical Facility Krnov Czech Republic
Palacký University Olomouc (CZ)
Department of Immunology Faculty of Medicine and Dentistry Palacky University Olomouc Olomouc Czech Republic
Corresponding author: Hamal, P.
ORCID: Svobodová, L.
Hamal, P.
Venue: Mycoses
Publisher: Wiley
Published: 2018-06-11
Volume: 61
Issue: 8
Pages: 576-586
ISSN: 0027-5557 (ISSN-L)
0933-7407
1439-0507
DOI: 10.1111/myc.12765
OpenAlex: W2791293936
Cited by: 42
References: 40
Citations by year: 2026: 4 · 2025: 3 · 2024: 7 · 2023: 7 · 2022: 12 · 2021: 1 · 2020: 4 · 2019: 4
FWCI: 1.70
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Mycoses (publishedVersion)
PubMed (publishedVersion)
Funders: Research Grant from Palacky University Olomouc, Czech Republic (IGA_LF_2017_031)
Topics: Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
Life Sciences › Immunology and Microbiology › Immunology › Immunodeficiency and Autoimmune Disorders
Keywords: invasive pulmonary aspergillosis, non-neutropenic patients, serum galactomannan, β-1,3-glucan, serological diagnosis, sensitivity and specificity, diagnostic test combination
MeSH terms: Adolescent, Adult, Aged, Aged, 80 and over, Antibodies, Fungal, Aspergillus fumigatus, Female, Galactose, Humans, Immunoglobulin A, Immunoglobulin G, Male, Mannans, Middle Aged, Predictive Value of Tests, Proteoglycans, Retrospective Studies, Sensitivity and Specificity, Serum, beta-Glucans, Invasive Pulmonary Aspergillosis, Young Adult

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Diagnostic value of serum galactomannan, (1,3)‐β‐d‐glucan, and Aspergillus fumigatus‐specific IgA and IgG assays for invasive pulmonary aspergillosis in non‐neutropenic patients

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