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Mycology

Utility of Galactomannan Enzyme Immunoassay and (1,3) β-d-Glucan in Diagnosis of Invasive Fungal Infections: Low Sensitivity for Aspergillus fumigatus Infection in Hematologic Malignancy Patients

R. Y. Hachem, D. P. Kontoyiannis, R. F. Chemaly, Y. Jiang, R. Reitzel, I. Raad
R. Y. Hachem
The Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
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  • For correspondence: rhachem@mdanderson.org
D. P. Kontoyiannis
The Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
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R. F. Chemaly
The Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
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Y. Jiang
The Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
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R. Reitzel
The Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
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I. Raad
The Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
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DOI: 10.1128/JCM.00506-08
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Article Figures & Data

Tables

  • TABLE 1.

    Demographic characteristics of case patients and negative control patients by infection type

    CharacteristicNo. (%) of patientsa
    Aspergillosis (n = 22)Candida infection (n = 23)Other mold infection (n = 17)
    Gender
        No. of males16 (73)12 (52)9 (53)
        No. of females6 (27)11 (48)8 (47)
    Age (yr) (median [range])60 (10-78)55 (23-81)51 (22-73)
    Underlying disease
        Hematological22 (100)11 (48)17 (100)
        Solid tumor0 (0)12 (52)0 (0)
    Bone marrow transplantation12 (55)2 (9)9 (53)
    Allogeneic hematopoietic stem cell transplant donor type12 (55)2 (9)7 (41)
    Site of IFI
        Lung21 (96)4 (23)
        Sinus1 (5)5 (29)
        Blood23 (100)2 (12)
        Skin6 (35)
    Antifungal therapy22 (100)21 (91)17 (100)
    Graft-versus-host disease8 (36)1 (4)5 (29)
    Neutropenia during prior mo12 (55)9 (39)9 (53)
    Neutropenia at infection onset5 (23)6 (26)6 (35)
    Use of steroids before infection15 (68)9 (39)11 (65)
    Use of steroids during infection17 (77)9 (39)11 (65)
    Immunotherapy18 (82)10 (44)13 (77)
    White blood cell count2 (9)2 (9)4 (24)
    Granulocyte-macrophage colony-stimulating factor4 (18)2 (9)4 (24)
    Granulocyte colony-stimulating factor16 (73)9 (39)12 (71)
    Gamma interferon1 (5)1 (4)6 (35)
    Breakthrough20 (91)11 (48)13 (77)
    • ↵ a Data represent numbers (percentages) of patients except where otherwise indicated.

  • TABLE 2.

    Performances of diagnostic tests for patients with IFI (per sample and per patient)

    Type of comparison and IFIAssaySensitivity (%)Specificity (%)PPV (%)aNPV (%)a
    Per sample
        Aspergillosis (n = 116)GM24999757
    BG58888367
        Candidemia (n = 102)GM2996754
    BG61888272
        Other mold infection (n = 77)GM6998362
    BG47887272
    Per patient
        Aspergillosis (n = 22)GM3810010061
    BG67908872
        Candidemia (n = 23)GM0100NA49
    BG62908769
        Other mold infection (n = 17)GM610010057
    BG63908375
    • ↵ a PPV, positive predictive value; NPV, negative predictive value.

  • TABLE 3.

    Performances of GM enzyme immunoassay and BG test for patients infected with different organisms (per sample)

    Test and organismSensitivity (%)Specificity (%)PPV (%)aNPV (%)a
    GM enzyme immunoassay
        A. fumigatus (n = 69)13999066
        Non-fumigatus Aspergillus species (n = 39)49999586
        Other mold (n = 77)6998362
    BG test
        A. fumigatus (n = 69)61887579
        Non-fumigatus Aspergillus species (n = 39)64886488
        Other mold (n = 76)47887272
    • ↵ a PPV, positive predictive value; NPV, negative predictive value.

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Utility of Galactomannan Enzyme Immunoassay and (1,3) β-d-Glucan in Diagnosis of Invasive Fungal Infections: Low Sensitivity for Aspergillus fumigatus Infection in Hematologic Malignancy Patients
R. Y. Hachem, D. P. Kontoyiannis, R. F. Chemaly, Y. Jiang, R. Reitzel, I. Raad
Journal of Clinical Microbiology Jan 2009, 47 (1) 129-133; DOI: 10.1128/JCM.00506-08

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Utility of Galactomannan Enzyme Immunoassay and (1,3) β-d-Glucan in Diagnosis of Invasive Fungal Infections: Low Sensitivity for Aspergillus fumigatus Infection in Hematologic Malignancy Patients
R. Y. Hachem, D. P. Kontoyiannis, R. F. Chemaly, Y. Jiang, R. Reitzel, I. Raad
Journal of Clinical Microbiology Jan 2009, 47 (1) 129-133; DOI: 10.1128/JCM.00506-08
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KEYWORDS

Mannans
mycoses
beta-Glucans

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