Serum Aspergillus galactomannan lateral flow assay for the diagnosis of invasive aspergillosis: a single center study
Citation
Serin, I., Dogu, M. H., (2021). Serum Aspergillus galactomannan Lateral Flow Assay for the Diagnosis of Invasive Aspergillosis: a single center study. Mycoses. https://doi.org/10.1111/myc.13265.Abstract
Background: Aspergillus species meet the most important group of invasive fungal diseases
(IFD) in immunosuppressed patients. Galactomannan is a polysaccharide antigen located in the
wall structure of Aspergillus. The most commonly used method for antigen detection is enzymelinked immunoassay (ELISA). Aspergillus galactomannan Lateral Flow Assay (LFA) constitutes
one of the new methods in the diagnosis of invasive aspergillosis (IA). The goal of this study is to
demonstrate efficacy of LFA in our patients and to compare it to synchronous ELISA results.
Methods: Galactomannan antigen was examined using both LFA and ELISA in serum samples
taken from patients who were followed up in our hematology clinic. All patients are classified in subgroups as "proven", "probable", and “possible" patients according to the last EORTC / MSG
guideline. Patients who met the “proven" IA criteria were included in the study as the gold
standard.
Results: A total of 87 patients were included in the study. Majority of patients had acute myeloid
leukemia (AML) (56.3%). Eleven (12.6%) were in "proven" IA group. LFA test showed a superior
diagnostic performance compared to ELISA (LFAAUC = 0.934 vs ELISAAUC = 0.545; p <0.001).
The LFA had a sensitivity of 90.9%, and a specificity of 90.8% for "0.5 ODI" in predicting IA
(PPV = 55.8%; NPV = 98.6%; p <0.001).
Conclusion: The most important finding of this study is that the specificity of LFA was found to
be higher for cut-off value of 0.5. It is recommended to combine the methods in many studies to
provide a better early diagnosis for IA.