Diagnostic value of the serum galactomannan assay for invasive aspergillosis

It is less useful in non-haematological patients

Nam Su Ku, Sang Hoon Han, JunYong Choi, Sun Bean Kim, Hye Won Kim, Su Jin Jeong, Chang Oh Kim, Young Goo Song, June Myung Kim

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: The serum galactomannan assay (GMA) has been widely used for the diagnosis of invasive aspergillosis (IA). GMA is mainly used in patients with haematological malignancies or in those who have undergone haematopoietic stem cell transplantation (HSCT). However, there are few data from non-haematological patients. We evaluated whether GMA is useful for the diagnosis of IA in non-haematological patients.Methods: Patients who were subjected to serum GMA testing from January 2007 to December 2009 were evaluated retrospectively. Patients with haematological diseases or who underwent HSCT were excluded from our analysis. According to the criteria of the European Organization for Research and Treatment of Cancer/Mycoses Study Group revised in 2008, the patients were categorized as proven, probable, possible, or non-IA. Proven and probable cases were defined as IA in this study.Results: Out of 778 patients, 13 (1.6%) had proven (n = 9) or probable (n = 4) IA. The sensitivity of the GMA was 23.1% (95% confidence interval (CI) 6.1-54.0%) and the specificity was 76.1% (95% CI 72.9-79.0%). The positive predictive value was 1.6% (95% CI 0.4-5.0%) and the negative predictive value was 98.3% (95% CI 96.8-99.1%). The likelihood ratios of a positive and negative test were 0.96 (95% CI 0.35-2.62) and 1.01 (95% CI 0.75-1.36), respectively. Conclusions: In this study, the sensitivity of the GMA for the diagnosis of IA was very low in non-haematological patients. Although the GMA test is considered useful for the diagnosis of IA in haematological patients, it had low diagnostic value for IA in non-haematological patients.

Original languageEnglish
Pages (from-to)600-604
Number of pages5
JournalScandinavian Journal of Infectious Diseases
Volume44
Issue number8
DOIs
Publication statusPublished - 2012 Aug 1

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Aspergillosis
Serum
Confidence Intervals
Hematopoietic Stem Cell Transplantation
galactomannan
Mycoses
Hematologic Diseases
Hematologic Neoplasms

All Science Journal Classification (ASJC) codes

  • Immunology and Microbiology(all)
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Ku, Nam Su ; Han, Sang Hoon ; Choi, JunYong ; Kim, Sun Bean ; Kim, Hye Won ; Jeong, Su Jin ; Kim, Chang Oh ; Song, Young Goo ; Kim, June Myung. / Diagnostic value of the serum galactomannan assay for invasive aspergillosis : It is less useful in non-haematological patients. In: Scandinavian Journal of Infectious Diseases. 2012 ; Vol. 44, No. 8. pp. 600-604.
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title = "Diagnostic value of the serum galactomannan assay for invasive aspergillosis: It is less useful in non-haematological patients",
abstract = "Background: The serum galactomannan assay (GMA) has been widely used for the diagnosis of invasive aspergillosis (IA). GMA is mainly used in patients with haematological malignancies or in those who have undergone haematopoietic stem cell transplantation (HSCT). However, there are few data from non-haematological patients. We evaluated whether GMA is useful for the diagnosis of IA in non-haematological patients.Methods: Patients who were subjected to serum GMA testing from January 2007 to December 2009 were evaluated retrospectively. Patients with haematological diseases or who underwent HSCT were excluded from our analysis. According to the criteria of the European Organization for Research and Treatment of Cancer/Mycoses Study Group revised in 2008, the patients were categorized as proven, probable, possible, or non-IA. Proven and probable cases were defined as IA in this study.Results: Out of 778 patients, 13 (1.6{\%}) had proven (n = 9) or probable (n = 4) IA. The sensitivity of the GMA was 23.1{\%} (95{\%} confidence interval (CI) 6.1-54.0{\%}) and the specificity was 76.1{\%} (95{\%} CI 72.9-79.0{\%}). The positive predictive value was 1.6{\%} (95{\%} CI 0.4-5.0{\%}) and the negative predictive value was 98.3{\%} (95{\%} CI 96.8-99.1{\%}). The likelihood ratios of a positive and negative test were 0.96 (95{\%} CI 0.35-2.62) and 1.01 (95{\%} CI 0.75-1.36), respectively. Conclusions: In this study, the sensitivity of the GMA for the diagnosis of IA was very low in non-haematological patients. Although the GMA test is considered useful for the diagnosis of IA in haematological patients, it had low diagnostic value for IA in non-haematological patients.",
author = "Ku, {Nam Su} and Han, {Sang Hoon} and JunYong Choi and Kim, {Sun Bean} and Kim, {Hye Won} and Jeong, {Su Jin} and Kim, {Chang Oh} and Song, {Young Goo} and Kim, {June Myung}",
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Diagnostic value of the serum galactomannan assay for invasive aspergillosis : It is less useful in non-haematological patients. / Ku, Nam Su; Han, Sang Hoon; Choi, JunYong; Kim, Sun Bean; Kim, Hye Won; Jeong, Su Jin; Kim, Chang Oh; Song, Young Goo; Kim, June Myung.

In: Scandinavian Journal of Infectious Diseases, Vol. 44, No. 8, 01.08.2012, p. 600-604.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Diagnostic value of the serum galactomannan assay for invasive aspergillosis

T2 - It is less useful in non-haematological patients

AU - Ku, Nam Su

AU - Han, Sang Hoon

AU - Choi, JunYong

AU - Kim, Sun Bean

AU - Kim, Hye Won

AU - Jeong, Su Jin

AU - Kim, Chang Oh

AU - Song, Young Goo

AU - Kim, June Myung

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N2 - Background: The serum galactomannan assay (GMA) has been widely used for the diagnosis of invasive aspergillosis (IA). GMA is mainly used in patients with haematological malignancies or in those who have undergone haematopoietic stem cell transplantation (HSCT). However, there are few data from non-haematological patients. We evaluated whether GMA is useful for the diagnosis of IA in non-haematological patients.Methods: Patients who were subjected to serum GMA testing from January 2007 to December 2009 were evaluated retrospectively. Patients with haematological diseases or who underwent HSCT were excluded from our analysis. According to the criteria of the European Organization for Research and Treatment of Cancer/Mycoses Study Group revised in 2008, the patients were categorized as proven, probable, possible, or non-IA. Proven and probable cases were defined as IA in this study.Results: Out of 778 patients, 13 (1.6%) had proven (n = 9) or probable (n = 4) IA. The sensitivity of the GMA was 23.1% (95% confidence interval (CI) 6.1-54.0%) and the specificity was 76.1% (95% CI 72.9-79.0%). The positive predictive value was 1.6% (95% CI 0.4-5.0%) and the negative predictive value was 98.3% (95% CI 96.8-99.1%). The likelihood ratios of a positive and negative test were 0.96 (95% CI 0.35-2.62) and 1.01 (95% CI 0.75-1.36), respectively. Conclusions: In this study, the sensitivity of the GMA for the diagnosis of IA was very low in non-haematological patients. Although the GMA test is considered useful for the diagnosis of IA in haematological patients, it had low diagnostic value for IA in non-haematological patients.

AB - Background: The serum galactomannan assay (GMA) has been widely used for the diagnosis of invasive aspergillosis (IA). GMA is mainly used in patients with haematological malignancies or in those who have undergone haematopoietic stem cell transplantation (HSCT). However, there are few data from non-haematological patients. We evaluated whether GMA is useful for the diagnosis of IA in non-haematological patients.Methods: Patients who were subjected to serum GMA testing from January 2007 to December 2009 were evaluated retrospectively. Patients with haematological diseases or who underwent HSCT were excluded from our analysis. According to the criteria of the European Organization for Research and Treatment of Cancer/Mycoses Study Group revised in 2008, the patients were categorized as proven, probable, possible, or non-IA. Proven and probable cases were defined as IA in this study.Results: Out of 778 patients, 13 (1.6%) had proven (n = 9) or probable (n = 4) IA. The sensitivity of the GMA was 23.1% (95% confidence interval (CI) 6.1-54.0%) and the specificity was 76.1% (95% CI 72.9-79.0%). The positive predictive value was 1.6% (95% CI 0.4-5.0%) and the negative predictive value was 98.3% (95% CI 96.8-99.1%). The likelihood ratios of a positive and negative test were 0.96 (95% CI 0.35-2.62) and 1.01 (95% CI 0.75-1.36), respectively. Conclusions: In this study, the sensitivity of the GMA for the diagnosis of IA was very low in non-haematological patients. Although the GMA test is considered useful for the diagnosis of IA in haematological patients, it had low diagnostic value for IA in non-haematological patients.

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