Clinical Application of Aspergillus Lateral Flow Device in Bronchoalveolar Lavage Fluid of Patients with Classic Risk Factors for Invasive Pulmonary Aspergillosis.

Clinical Application of Aspergillus Lateral Flow Device in Bronchoalveolar Lavage Fluid of Patients with Classic Risk Factors for Invasive Pulmonary Aspergillosis.

Mycoses. 2019 Oct 03;:

Authors: Linder KA, Kauffman CA, Zhou S, Miceli MH

Abstract
BACKGROUND: The diagnosis of invasive pulmonary aspergillosis (IPA) remains challenging. We evaluated the performance characteristics of a newly formatted Aspergillus lateral flow test, AspLFD, in bronchalveolar 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 AspLFD according to manufacturer’s directions. Results were read by 2 independent observers, and test performance was calculated.
RESULTS: Age, gender, and underlying risk factors, except for neutropenia and hematologic malignancy, were similar between IPA cases and controls. Seven patients (50%) in the IPA group received a mold-active agent within 5 days prior to bronchoscopy compared with only 3 patients (11%) in the control group, p=.004. Of 14 patients with proven/probable IPA, AspLFD was positive in 3 and negative in 9; two tests yielded invalid results. All 28 control patients had a negative AspLFD test. AspLFD showed low sensitivity (25%, 95% C.I.: 5.5% to 57.2%), but high specificity (100%. (95% C.I.: 87.7% to 100%).
CONCLUSIONS: A positive AspLFD 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 AspLFD is limited by low sensitivity.

PMID: 31581342 [PubMed – as supplied by publisher]

Source: Industry