Abstract：
OBJECTIVES:Galactomannan (GM) and Aspergillus DNA detection are useful tools for the diagnosis of invasive pulmonary aspergillosis (IPA), primarily in blood and bronchoscopy samples. This study aimed to evaluate the utility of both markers for detection of Aspergillus in sputum from patients with allergic bronchopulmonary aspergillosis (ABPA) and chronic pulmonary aspergillosis (CPA). METHODS:ABPA or CPA demographic patient data were retrieved. This retrospective observational audit included 159 patients with at least one sputum pair. 223 sputum sample pairs were analysed, as well as six control samples for GM only. Real time PCR was performed following sputum DNA extraction using the MycAssay™ Aspergillus kit and cycle thresholds were subtracted from 38 to give positive values (transformed Ct, TCt). RESULTS:The mean age of the patients was 61.81years (SD: ±11.06; range 29-100). One hundred and twenty-six (79.2%) had CPA. Cultures were positive for fungi in 13.1% of the samples, and A. fumigatus was the commonest (11.9%) fungus isolated. Receiver operating characteristic (ROC curve) analysis of sputum GM comparing TCt of >0.0, and >2.0 to derive GMI cut-off values showed a cut-off of 6.5. About 50% of sputa with strongly positive PCR values had GM values>6.5. Two of six (33%) control samples had GM indices>6.5. CONCLUSION:It is not clear that GM determinations in sputum are useful for diagnosis of either CPA or ABPA, or following therapy.
journal_name
J Microbiol Methodsjournal_title
Journal of microbiological methodsauthors
Fayemiwo S,Moore CB,Foden P,Denning DW,Richardson MDdoi
10.1016/j.mimet.2017.06.016subject
Has Abstractpub_date
2017-09-01 00:00:00pages
32-39eissn
0167-7012issn
1872-8359pii
S0167-7012(17)30166-5journal_volume
140pub_type
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