Title |
Multicenter evaluation of a lateral-flow device test for diagnosing invasive pulmonary aspergillosis in ICU patients
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Published in |
Critical Care, December 2015
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DOI | 10.1186/s13054-015-0905-x |
Pubmed ID | |
Authors |
Susanne Eigl, Juergen Prattes, Michaela Lackner, Birgit Willinger, Birgit Spiess, Mark Reinwald, Brigitte Selitsch, Michael Meilinger, Peter Neumeister, Frederike Reischies, Albert Wölfler, Reinhard B Raggam, Holger Flick, Stephan Eschertzhuber, Robert Krause, Dieter Buchheidt, Christopher R Thornton, Cornelia Lass-Flörl, Martin Hoenigl |
Abstract |
The incidence of invasive pulmonary aspergillosis (IPA) in intensive care unit (ICU) patients is increasing and early diagnosis of the disease and treatment with antifungal drugs is critical for patient survival. Serum biomarker tests for IPA typically give false negative results in non-neutropenic patients and galactomannan detection, the preffered diagnostic test for IPA using bronchoalveolar lavage (BAL), is often not readily available. Novel approaches to IPA detection in ICU patients are needed. In this multicenter study we evaluate the performance of an Aspergillus lateral-flow device (LFD) test for BAL IPA detection in critically ill patients. 149 BAL samples from 133 ICU patients were included in this semi-prospective study. Participating centers were the Medical University Hospitals of Graz, Vienna and Innsbruck in Austria and the University Hospital of Mannheim, Germany. Fungal infections were classified according to modified EORTC/MSG criteria. Two patients (four BALs) had proven IPA, 14 patients (16 BALs) had probable IPA, 20 patients (21 BALs) possible IPA and 97 patients (108 BALs) did not fulfill IPA criteria. Sensitivity, specificity, negative predictive value, positive predictive value and diagnostic odds ratio for diagnosing proven and probable IPA using LFD tests of BAL were 80%, 81%, 96%, 44% and 17.6 respectively. Fungal BAL culture exhibited a sensitivity of 50% with a specificity of 85%. LFD tests of BAL showed promising results for IPA diagnosis in ICU patients. Furthermore, the LFD can be performed easily and provides rapid results. Therefore, it may be a reliable alternative for IPA diagnosis in ICU patients if GM results are not available rapidly. ClinicalTrials.gov NCT02058316 . Registered 20 January 2014. |
X Demographics
Geographical breakdown
Country | Count | As % |
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Unknown | 3 | 100% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 1 | 33% |
Practitioners (doctors, other healthcare professionals) | 1 | 33% |
Scientists | 1 | 33% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Brazil | 1 | 1% |
Unknown | 79 | 99% |
Demographic breakdown
Readers by professional status | Count | As % |
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Researcher | 17 | 21% |
Student > Bachelor | 9 | 11% |
Student > Master | 7 | 9% |
Professor | 6 | 8% |
Student > Ph. D. Student | 6 | 8% |
Other | 14 | 18% |
Unknown | 21 | 26% |
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Medicine and Dentistry | 30 | 38% |
Biochemistry, Genetics and Molecular Biology | 6 | 8% |
Agricultural and Biological Sciences | 5 | 6% |
Engineering | 4 | 5% |
Immunology and Microbiology | 4 | 5% |
Other | 7 | 9% |
Unknown | 24 | 30% |