KMID : 0338420150300060899
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The Korean Journal of Internal Medicine 2015 Volume.30 No. 6 p.899 ~ p.905
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Serum galactomannan levels in the diagnosis of invasive aspergillosis
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:Yildiz Okuturlar
:Fahir Ozkalemkas/:Beyza Ener/:Sibel Ocak Serin/:Esra Kazak/:Tulay Ozcelik/:Vildan Ozkocaman/:Hasan Atilla Ozkan/:Halis Akalin/:Meral Gunaldi/:Ridvan Ali
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Abstract
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Background/Aims: In this study, the sensitivity-specificity of galactomannan-enzyme immunoassay (GM-EIA) with a cut-off value of 0.5 for a single, two, or three consecutive positivity in the diagnosis of invasive pulmonary aspergillosis (IPA) in neutropenic patients with hematological malignancy was investigated.
Methods: IPA was classified as ¡°proven,¡± ¡°probable,¡± or ¡°possible¡± as described in the guidelines prepared by the European Organization for Research and Treatment of Cancer and Mycoses Study Group.¡± Serum samples were collected from the patients twice a week throughout their hospitalization. A total of 1,385 serum samples, with an average of 8.3 samples per episode, were examined.
Results: Based on the 165 febrile episodes in 106 patients, 80 (48.5%) were classified as IPA (4 proven, 11 probable, 65 possible) and 85 (51.5%) as non-IPA. The sensitivity/ specificity was 100%/27.1% for a single proven/probable IPA with the cut of value of GM-EIA ¡Ã 0.5, 86.7%/71.8% for two consecutive positive results, and 73.3%/85.9% for three consecutive positive results.
Conclusions: With the galactomannan levels measured twice a week, consecutive sensitivity decreased and specificity increased. Therefore, an increase may be obtained in sensitivity-specificity by more frequent monitoring of GM-EIA starting from the first day of positivity is detected.
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KEYWORD
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Invasive aspergillosis, Galactomannan test, Cut-off value, Sensitivity and specificity, Enzyme-linked immunosorbent assay
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