ArticleCureus2025
A Prospective Observational Study on the Evaluation of the Galactomannan Test in the Diagnosis of Invasive Aspergillosis.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Article
- Biomarkers in the Diagnosis of Aspergillosis.Journal of fungi (Basel, Switzerland) · 2026Review
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5 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundInvasive aspergillosis (IA) is a life-threatening opportunistic fungal infection, particularly in immunocompromised patients. Early, reliable diagnosis is essential for timely management.
objectiveTo assess the diagnostic performance of the galactomannan enzyme immunoassay (GEIA) in bronchoalveolar lavage (BAL) fluid and serum, comparing with potassium hydroxide (KOH) microscopy, high-resolution CT (HRCT) chest, and culture (as reference).
methodsIn this prospective, single-center observational study (January-December 2018), BAL and/or serum samples from patients clinically suspected of IA were tested using the Platelia™ Aspergillus Galactomannan EIA kit (Bio-Rad, France). Results at two optical density (OD) cut‑offs (≥ 0.5 and > 1.0) were compared against culture, KOH microscopy, and HRCT. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and 95% confidence intervals were calculated. Pairwise comparisons used McNemar's test.
resultsAmong 159 BAL samples, GEIA positivity was 51.6% (OD ≥ 0.5) and 39.0% (OD > 1.0). At OD ≥ 0.5, BAL galactomannan (GM) sensitivity was 93.3% (95% CI: 83.8-97.9), specificity 71.4% (95% CI: 61.4-79.9), PPV 63.4%, NPV 97.4%, and accuracy 79.9%. At OD > 1.0, sensitivity was 92.6% (95% CI: 82.9-97.9), specificity 88.6% (95% CI: 80.8-93.8), PPV 80.7%, NPV 95.9%, and accuracy 89.9%. KOH microscopy and HRCT in the BAL cohort achieved sensitivities of 90.7% and 85.2% and specificities of 77.1% and 80.0%, respectively. McNemar's test showed BAL GM (OD > 1.0) was significantly superior to KOH (p = 0.003) and HRCT (p = 0.005). In 60 patients tested with serum GM (OD ≥ 0.5), sensitivity was 84.0% (95% CI: 62.9-95.0), specificity 80.0% (95% CI: 61.4-92.3), PPV 75.0%, NPV 87.5%, and accuracy 81.7%.
conclusionsIn this cohort, BAL GM testing provided excellent sensitivity and, especially at OD > 1.0, improved specificity relative to conventional methods. Serum GM performed moderately well, but with lower sensitivity and specificity. BAL GM (OD > 1.0) may provide an optimal balance for non-culture-based diagnosis of IA, though results should be interpreted in the clinical context. Future multicenter studies incorporating polymerase chain reaction (PCR) and β-D-glucan are warranted to validate these findings.
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