Detection of Galactomannan Antigenemia by Enzyme Immunoassay for the Diagnosis of Invasive Aspergillosis: Variables That Affect Performance
Invasive aspergillosis (IA) is a frequent complication of blood or marrow transplantation. Previous studies have reported that the Aspergillus galactomannan enzyme immunoassay (GM EIA) may be a useful diagnostic tool for IA, but its sensitivity is variable. We examined the performance of the GM EIA...
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| Veröffentlicht in: | The Journal of infectious diseases 2004-08, Vol.190 (3), p.641-649 |
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| creator | Marr, Kieren A. Balajee, S. Arunmozhi McLaughlin, Lisa Tabouret, Marc Bentsen, Christopher Walsh, Thomas J. |
| description | Invasive aspergillosis (IA) is a frequent complication of blood or marrow transplantation. Previous studies have reported that the Aspergillus galactomannan enzyme immunoassay (GM EIA) may be a useful diagnostic tool for IA, but its sensitivity is variable. We examined the performance of the GM EIA in 986 serum samples from 67 patients. Results demonstrated that decreasing the index cutoff for positivity to 0.5 increased its sensitivity, with minimal loss of specificity. The low cutoff increased the duration of test positivity before diagnosis by clinical means. Sensitivity was highest in patients who did not receive preventative mold-active antifungals (87.5%). A rabbit model demonstrated that the level of circulating antigen correlated with the tissue fungus burden. A quantifiable response to antifungal therapy in clinical samples and the rabbit model supports the development of this assay for early diagnosis and therapeutic monitoring. The 0.5 cutoff may allow for better performance as an early diagnostic test. |
| doi_str_mv | 10.1086/422009 |
| format | Article |
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A rabbit model demonstrated that the level of circulating antigen correlated with the tissue fungus burden. A quantifiable response to antifungal therapy in clinical samples and the rabbit model supports the development of this assay for early diagnosis and therapeutic monitoring. 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Arunmozhi</creatorcontrib><creatorcontrib>McLaughlin, Lisa</creatorcontrib><creatorcontrib>Tabouret, Marc</creatorcontrib><creatorcontrib>Bentsen, Christopher</creatorcontrib><creatorcontrib>Walsh, Thomas J.</creatorcontrib><title>Detection of Galactomannan Antigenemia by Enzyme Immunoassay for the Diagnosis of Invasive Aspergillosis: Variables That Affect Performance</title><title>The Journal of infectious diseases</title><addtitle>J Infect Dis</addtitle><addtitle>J Infect Dis</addtitle><description>Invasive aspergillosis (IA) is a frequent complication of blood or marrow transplantation. Previous studies have reported that the Aspergillus galactomannan enzyme immunoassay (GM EIA) may be a useful diagnostic tool for IA, but its sensitivity is variable. We examined the performance of the GM EIA in 986 serum samples from 67 patients. Results demonstrated that decreasing the index cutoff for positivity to 0.5 increased its sensitivity, with minimal loss of specificity. The low cutoff increased the duration of test positivity before diagnosis by clinical means. Sensitivity was highest in patients who did not receive preventative mold-active antifungals (87.5%). A rabbit model demonstrated that the level of circulating antigen correlated with the tissue fungus burden. A quantifiable response to antifungal therapy in clinical samples and the rabbit model supports the development of this assay for early diagnosis and therapeutic monitoring. 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Psychology</subject><subject>Fungal infections</subject><subject>Fungemia - diagnosis</subject><subject>Fungemia - microbiology</subject><subject>Fungi</subject><subject>Health care administration</subject><subject>Humans</subject><subject>Immunoenzyme Techniques</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>Lung Diseases, Fungal - diagnosis</subject><subject>Lung Diseases, Fungal - microbiology</subject><subject>Male</subject><subject>Mannans - blood</subject><subject>Medical sciences</subject><subject>Microbiology</subject><subject>Middle Aged</subject><subject>Neutropenia</subject><subject>Rabbits</subject><subject>Sensitivity and Specificity</subject><subject>Symptoms</subject><issn>0022-1899</issn><issn>1537-6613</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkdFu0zAUhiMEYt2ANwCZSXAXOLYTx-aubGOtNAkuCpq4sdzkuHNJ7GInE-UVeGlStdoQEuLKF_-n7_icP8ueUXhDQYq3BWMA6kE2oSWvciEof5hNABjLqVTqKDtOaQ0ABRfV4-yIlqzgquCT7Nc59lj3LngSLLk0ran70BnvjSdT37sVeuycIcstufA_tx2SedcNPpiUzJbYEEl_g-TcmZUPyaWdZO5vTXK3SKZpg3Hl2naXvCNfTHRm2WIiixvTk6m142DyCeNoGSfW-CR7ZE2b8OnhPck-f7hYnM3yq4-X87PpVV4Xkva5Yk0NyOSyGDdXVDJac1NzQRvaQAO2pLK0yqICI6EUaCTawqqGMmjKJVb8JHu9925i-D5g6nXnUo1tazyGIWkhhJRlBf8FqQSuOOyMp3-B6zBEPy6hGeOKMlrQe1sdQ0oRrd5E15m41RT0rkS9L3EEXxxsw7LD5h47tDYCrw6ASbVpbRyv59IfnCqVorv_v9xzYdj8e9jzPbNOfYh3FAeoKsHlmOf73KUef9zlJn7TouJVqWfXXzV7P1PXFV1oyX8DkTHGeg</recordid><startdate>20040801</startdate><enddate>20040801</enddate><creator>Marr, Kieren A.</creator><creator>Balajee, S. Arunmozhi</creator><creator>McLaughlin, Lisa</creator><creator>Tabouret, Marc</creator><creator>Bentsen, Christopher</creator><creator>Walsh, Thomas J.</creator><general>The University Chicago Press</general><general>University of Chicago Press</general><general>Oxford University Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>M7N</scope><scope>7X8</scope></search><sort><creationdate>20040801</creationdate><title>Detection of Galactomannan Antigenemia by Enzyme Immunoassay for the Diagnosis of Invasive Aspergillosis: Variables That Affect Performance</title><author>Marr, Kieren A. ; Balajee, S. 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Psychology</topic><topic>Fungal infections</topic><topic>Fungemia - diagnosis</topic><topic>Fungemia - microbiology</topic><topic>Fungi</topic><topic>Health care administration</topic><topic>Humans</topic><topic>Immunoenzyme Techniques</topic><topic>Infections</topic><topic>Infectious diseases</topic><topic>Lung Diseases, Fungal - diagnosis</topic><topic>Lung Diseases, Fungal - microbiology</topic><topic>Male</topic><topic>Mannans - blood</topic><topic>Medical sciences</topic><topic>Microbiology</topic><topic>Middle Aged</topic><topic>Neutropenia</topic><topic>Rabbits</topic><topic>Sensitivity and Specificity</topic><topic>Symptoms</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Marr, Kieren A.</creatorcontrib><creatorcontrib>Balajee, S. Arunmozhi</creatorcontrib><creatorcontrib>McLaughlin, Lisa</creatorcontrib><creatorcontrib>Tabouret, Marc</creatorcontrib><creatorcontrib>Bentsen, Christopher</creatorcontrib><creatorcontrib>Walsh, Thomas J.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Marr, Kieren A.</au><au>Balajee, S. 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| source | MEDLINE; Jstor Complete Legacy; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| subjects | Adolescent Adult Aged Animals Antifungals Antigens, Fungal - blood Aspergillosis Aspergillosis - diagnosis Aspergillosis - microbiology Aspergillus Aspergillus - isolation & purification Biological and medical sciences Bone marrow Bone Marrow Transplantation - adverse effects Child Child, Preschool Disease Models, Animal Female Fundamental and applied biological sciences. Psychology Fungal infections Fungemia - diagnosis Fungemia - microbiology Fungi Health care administration Humans Immunoenzyme Techniques Infections Infectious diseases Lung Diseases, Fungal - diagnosis Lung Diseases, Fungal - microbiology Male Mannans - blood Medical sciences Microbiology Middle Aged Neutropenia Rabbits Sensitivity and Specificity Symptoms |
| title | Detection of Galactomannan Antigenemia by Enzyme Immunoassay for the Diagnosis of Invasive Aspergillosis: Variables That Affect Performance |
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