Clinical application of Aspergillus lateral flow device in bronchoalveolar lavage fluid of patients with classic risk factors for invasive pulmonary aspergillosis. Issue 12 (21st October 2019)

• Record Type: Journal Article
• Authors: Linder, Kathleen A.; Kauffman, Carol A.; Zhou, Shiwei; Miceli, Marisa H.
• Is Part Of: Mycoses. Volume 62:Issue 12(2019)
• Page Start: 1189
• Page End: 1193
• Publication Date: 2019-10-21
• Subjects: bronchoalveolar lavage -- diagnostics -- invasive aspergillosis -- lateral flow device; Pathogenic fungi -- Periodicals; Medical mycology -- Periodicals; 616.969
• DOI: 10.1111/myc.13012
• Languages: English
• ISSNs: 0933-7407

Abstract

Summary: Background: The diagnosis of invasive pulmonary aspergillosis (IPA) remains challenging. We evaluated the performance characteristics of a newly formatted Aspergillus lateral flow test, Asp LFD, in bronchoalveolar lavage (BAL) fluid from patients with classic risk factors for IPA. Methods: Prospectively banked BAL samples from 14 patients with proven or probable IPA defined by EORTC/MSG criteria and 28 BAL samples from age‐matched high‐risk patients without IPA were tested with Asp LFD according to manufacturer's directions. Results were read by two independent observers, and test performance was calculated. Results: Age, gender and underlying risk factors, except for neutropenia and haematological malignancy, were similar between IPA cases and controls. Seven patients (50%) in the IPA group received a mould‐active agent within 5 days prior to bronchoscopy compared with only three patients (11%) in the control group, P = .004. Of 14 patients with proven/probable IPA, Asp LFD was positive in 3 and negative in 9; two tests yielded invalid results. All 28 control patients had a negative Asp LFD test. Asp LFD showed low sensitivity (25%, 95% CI: 5.5% to 57.2%), but high specificity (100%. (95% CI: 87.7% to 100%). Conclusions: A positive Asp LFD test in BAL fluid of patients with classic risk factors for IPA could be useful to support the diagnosis of proven/probable IPA because of its high specificity. However, as a stand‐alone test for IPA, the use of Asp LFD is limited by low sensitivity.