International Journal of Current Microbiology and Applied Sciences | 2019
Glactomannan Index as a Rapid Diagnostic Tool for Invasive Pulmonary Aspergillosis in Patients with Chronic Lung Diseases
Abstract
Invasive aspergillosis has increased considerably in recent years; this serious infection was primarily described in severely immunocompromised patients and patients with moderate levels of immune suppression. We conducted this study on 85 patients admitted to the chest department and chest ICU with severe exacerbations of chronic lung diseases in the period from April 2018 to April 2019. We collected tracheal aspirates BAL fluid and blood samples for isolation of Aspergillus spp. by convectional culture and assay of galactomannan level in these samples using ELISA. Aspergillus spp. was isolated from (14.3%) of tracheobroncheal aspirate samples, (11%) BAL samples and (2.4%) blood samples. Aspergillus fumigatus represented (70%) of isolates while Aspergillus niger represented (25%). Galactomannan antigen was positively detected in (9.4%) of serum samples, (22%) of tracheobronchial aspirates, and in (22.2%) bronchoalveoalar lavage fluid samples. The sensitivity (52%) and specificity (48%) of culture were much lower than the sensitivity and specificity of galactomannan detection (92%) and (85%) respectively. proven IA patient category represented (2.4%), while Probable IA represented (22.4%), and possible IA represented (22.2%). invasive aspergillosis could be a cause of exacerbation in patients with chronic chest diseases and a cause of their unresponsiveness to relevant treatment. Galactomannan antigen detection is a rapid sensitive diagnostic test of IA in those patients that helps the clinicians to rapidly diagnose IA and start antifungal therapy. K e y w o r d s