Observational studyCritical care (London, England)2016
Does galactomannan testing increase diagnostic accuracy for IPA in the ICU? A prospective observational study.
Observational study in Critical care (London, England), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01866020 (Diagnosis of Invasive Pulmonary Aspergillosis), which is not on this map. Cited by 27 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Diagnosis of Invasive Pulmonary Aspergillosis (IPA) in Critically Ill Patients - a Prospective Clinical Trial in the Department of Intensive Care, University Medical Center Hamburg-Eppendorf (UKE)
Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- Galactomannan detection in broncho-alveolar lavage fluid for invasive aspergillosis in immunocompromised patients.The Cochrane database of systematic reviews · 2019Pooled it
- Intensive care medicine research agenda on invasive fungal infection in critically ill patients.Intensive care medicine · 2017Pooled it
- Prognostic Value of Serum and Bronchoalveolar Lavage Fluid Galactomannan Levels in Invasive Aspergillosis: An 8-Year Experience at a Tertiary Cancer Center.Journal of fungi (Basel, Switzerland) · 2025Article
- An Observational Cohort Study of Bronchoalveolar Lavage Fluid Galactomannan andOpen forum infectious diseases · 2025Article
- Diagnostic Approach to Pneumonia in Immunocompromised Hosts.Journal of clinical medicine · 2025Review
- Clinical Features of COVID-19 Associated Pulmonary Aspergillosis: A Multicenter, Retrospective Study.The clinical respiratory journal · 2025Article
- Article
- Severe mold fungal infections in critically ill patients with COVID-19.Future microbiology · 2024Review
- Invasive pulmonary aspergillosis among patients with severe community-acquired pneumonia and influenza in ICUs: a retrospective cohort study.Pneumonia (Nathan Qld.) · 2024Article
- An observational cohort study of bronchoalveolar lavage fluid galactomannan andmedRxiv : the preprint server for health sciences · 2024Article
- Impact of Invasive Pulmonary Aspergillosis in Critically Ill Surgical Patients with or without Solid Organ Transplantation.Journal of clinical medicine · 2023Article
- COVID-19-Associated Pulmonary Aspergillosis (CAPA) in Northern Greece during 2020-2022: A Comparative Study According to the Main Consensus Criteria and Definitions.Journal of fungi (Basel, Switzerland) · 2023Article
- Analysis of Fungal and Bacterial Co-Infections in Mortality Cases among Hospitalized Patients with COVID-19 in Taipei, Taiwan.Journal of fungi (Basel, Switzerland) · 2022Article
- Taskforce report on the diagnosis and clinical management of COVID-19 associated pulmonary aspergillosis.Intensive care medicine · 2021Article
- Epidemiological Correlation of PulmonaryJournal of fungi (Basel, Switzerland) · 2021Article
- Clinical Characteristics and Prognostic Risk Factors of Patients With Proven Invasive Pulmonary Aspergillosis: A Single-Institution Retrospective Study.Frontiers in medicine · 2021Article
- Pulmonary Aspergillosis in Patients with Suspected Ventilator-associated Pneumonia in UK ICUs.American journal of respiratory and critical care medicine · 2020Article
- Article
- Utility of serum galactomannan antigen testing combined with chest computed tomography for early diagnosis of invasive pulmonary aspergillosis in patients with hematological malignancies with febrile neutropenia after antifungal drug treatment.The Journal of international medical research · 2019Article
- A novel diagnosis scoring model to predict invasive pulmonary aspergillosis in the intensive care unit.Saudi medical journal · 2019Article
Corrections and comments
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAn algorithm for distinguishing invasive pulmonary aspergillosis (IPA) in critically ill patients (AspICU) has been proposed but not tested.
methodsThis was a prospective observational study applying the AspICU protocol to patients with positive Aspergillus culture (PAC group) and those with negative aspergillus culture but positive galactomannan test in respiratory tract samples (only positive galactomannan (OPG group)). Patients underwent a standardized diagnostic workup with bronchoscopy, computed tomography (CT), and galactomannan determination in serum and bronchoalveolar lavage fluid (BALF).
resultsWe included 85 patients in the study. Of these, 43 had positive aspergillus cultures and 42 patients had only a positive galactomannan test. There were no statistically significant differences in baseline characteristics, underlying conditions or ICU scores between the two groups. The galactomannan titre in BALF was significantly higher in the positive aspergillus culture (PAC) group (enzyme immunoassay (EIA) 5.9, IQR 3.2-5.7) than in the OPG group (EIA 1.7, IQR 0.9-4.5) (p < 0.001). Classic features of IPA were detected on CT in 37.5 % and 36.6 % of patients in the PAC and OPG groups, respectively. There were no statistically significant differences between the PAC and the OPG group in relation to AspICU or European Organization for the Research and Treatment of Cancer (EORTC) criteria. A positive aspergillus culture was a stronger trigger for initiating antimycotic treatment than positive BALF galactomannan: 88.4 % of patients in the PAC group were regarded by clinicians as having IPA and received antimycotic treatment as opposed to 59.5 % in the OPG group (p = 0.002). The 180-day mortality was 58.1 % in the PAC group and 59.5 % in the OPG group.
conclusionsThe inclusion of BALF galactomannan as an additional entry criterion for the AspICU clinical algorithm could increase the diagnostic sensitivity for IPA in ICU patients.
trial registrationThe study was registered at ClinicalTrials.gov (registration number NCT01866020 ) on 27 May 2013.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.