The role of galactomannan test results in the diagnosis of pediatric invasive aspergillosis. Issue 4 (3rd April 2022)

• Record Type: Journal Article
• Authors: Özen, Seval; Özdemir, Halil; Evren, Ebru; Taşkın, Esra Çakmak; Arga, Gül; Konca, Hatice Kübra; Çakmaklı, Hasan Fatih; Haskoloğlu, Şule; Okulu, Emel; Dinçaslan, Handan; İnce, Elif; İleri, Talia; Taçyıldız, Nurdan; Doğu, Figen; Us, Ebru; Karahan, Zeynep Ceren; Fitöz, Suat; Kendirli, Tanıl; Kuloğlu, Zarife; Tutar, Ercan; İkincioğulları, Aydan; Ünal, Emel; Ertem, Mehmet; İnce, Erdal; Çiftçi, Ergin
• Is Part Of: Infectious diseases. Volume 54:Issue 4(2022)
• Page Start: 269
• Page End: 276
• Publication Date: 2022-04-03
• Subjects: Invasive aspergillosis -- febrile neutropenia -- piperacillin-tazobactam -- odds ratio -- sensitivity -- specificity; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; 616.9
• DOI: 10.1080/23744235.2021.2008486
• Languages: English
• ISSNs: 2374-4235

Abstract

Abstract: Background: Invasive aspergillosis (IA) is an important cause of morbidity and mortality in immunosuppressed children. Early detection of the infection can improve prognosis in this patient population. Objectives: To investigate the utility of Aspergillus galactomannan antigen assay (GM-EIA) as a diagnostic tool for IA in at-risk paediatric patients. Patients/Methods: For the study, 659 GM-EIA results from 59 patients diagnosed with IA and 3368 GM-EIA results from 351 subjects without evidence for IA (controls) were reviewed retrospectively. Three cut-off values (i.e. ≥0.5, ≥1, ≥1.5) were specified to determine GM-EIA positivity. Results: The median age was 6.3 years for boys and 14.5 years for girls. There was a significant difference between the girls and boys in terms of age ( p < 0.01). For proven/probable/possible IA patients, sensitivity of 67.8% and specificity of 59.8% were detected when the ≥0.5 cut-off value was used for GM-EIA-positivity. The specificity increased to 80% at the cut-off of ≥1 and to 88% at the cut-off of ≥1.5. False positivity rates were 9.14, 3, and 1.45% at the ≥0.5, ≥1 and ≥1.5 cut-offs respectively. In the proven/probable IA group, sensitivity and negative predictive values were 86.9 and 97.2% at the ≥0.5 cut-off, 85.7 and 97.9%, at the ≥1 cut-off and 84.2 and 98.1% at ≥1.5 cut-off respectively. The positive likelihood ratio was 7.57 and the odds ratio was 42.67 at ≥1.5 cut-off. Conclusion: The GM-EIA may be used for both screening and diagnostic purposes in paediatric patients using a cut-off value of ≥1.5 for GM-EIA positivity.