Galactomannan Antigenemia for the Diagnosis of Invasive Aspergillosis in Neutropenic Patients with Hematological Disorders
Chusana Suankratay MD, PhD*, Phichai Kanitcharaskul MD**, Kesinee Arunyingmongkol BPH*
Affiliation : * Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Chulalongkorn University ** Division of Hematology, Department of Medicine, Faculty of Medicine, Chulalongkorn University
Objectives : Invasive aspergillosis (IA) is among the most common invasive fungal infections in neutropenic
patients with hematological disorders in the authors’ institution, King Chulalongkorn Memorial Hospital
(KCMH), Bangkok, Thailand. Previous studies have reported the Aspergillus galactomannan enzyme
immunosorbent assay (GM EIA) may be a useful diagnostic tool for IA. The authors evaluated the performance
of the GM EIA for the diagnosis and monitoring of the course of IA in KCMH.
Materials and Methods : The authors prospectively performed the study from June 2002 to January 2004 in a
consecutive series of adult neutropenic patients with hematological disorders who were at risk for developing
IA. During hospitalization, serum galactomannan levels were measured once or twice weekly using the
Platellia Aspergillus EIA test kit. The sensitivity and specificity of the GM EIA were calculated according to
the proportion of patients with true and false positive and negative tests.
Results : There were 50 treatment episodes in 44 patients with 5 proven, 12 probable, and 33 possible or no IA.
The cutoff GM index of > 0.75 was determined with a sensitivity of 94.1% and a specificity of 78.8%. There was
a close relationship between clinical outcome and the kinetics of GM indices.
Conclusion : The GM EIA is a useful diagnostic tool for the diagnosis and monitoring of the course of IA in the
presented institute.
Keywords : Galactomannan antigen, Galactomannan enzyme immunosorbent assay, Invasive fungal infection, Invasive aspergillosis, Febrile neutropenia
