PDF(Pubmed)
Abstract：
Aspergillus species can colonize and infect immunocompetent and immunocompromised hosts. Conventional fungal identification depends on microscopic analysis and microorganism medium growth. Other diagnostic methods, non-growth dependent, to invasive fungal infections, are the biomarkers that detect circulating polysaccharides, for example, 1-3-β-d-Glucan and galactomannan. Both are polysaccharides present on the external layer of fungi cell wall and can be detected in clinical samples during the growth of the fungus in the patient. This study aimed to compare the galactomannan detection of Lateral Flow Assay and Enzyme Immunoassay methods in Bronchoalveolar Lavage Fluid. The galactomannan antigen in Bronchoalveolar Lavage Fluid was measured using Enzyme Immunoassay according to the manufacturer\'s instructions (PLATELIA ASPERGILLUS™ BioRad) and, using a Lateral Flow Assay according to the manufacturer\'s instructions (Galactomannan LFA IMMY©). The 71 samples were Bronchoalveolar Lavage Fluid of patients hospitalized at Unicamp Clinical Hospital between 2019 and 2021; of these samples 12/71 (16.9 %) resulted in positive Galactomannan-Lateral Flow Assay. In contrast, Galactomannan-Enzyme Immunoassay resulted as positive in 9/71 (12.6 %) samples, a difference that showed not significant statistically (p-value = 0.36) Comparing both assays\' results identified 8 divergences between them, about 11 % of the total sample. The Sensitivity (73.3 %), Specificity (92.35 %), Positive Predictive Value (62.85 %) and Negative Predictive Value (95.15 %) of Lateral Flow Assay were calculated using the Galactomannan Enzyme Immunoassay as standard. The Lateral Flow Assay demonstrated good results when compared with the Enzyme Immunoassay.
摘要：
曲霉属物种可以定殖并感染免疫活性和免疫受损的宿主。常规的真菌鉴定取决于显微镜分析和微生物培养基生长。其他诊断方法,不依赖增长，侵袭性真菌感染，是检测循环多糖的生物标志物，例如,1-3-β-d-葡聚糖和半乳甘露聚糖。两者都是存在于真菌细胞壁外层上的多糖，并且可以在患者真菌生长期间在临床样品中检测到。本研究旨在比较支气管肺泡灌洗液中半乳甘露聚糖的侧流检测和酶免疫检测方法。根据制造商的说明书（PLATELIAASPERGILLUS™BioRad），使用酶免疫分析法测量支气管肺泡灌洗液中的半乳甘露聚糖抗原，根据制造商的说明（半乳甘露聚糖LFAIMMY）使用侧流测定。71个样本是2019年至2021年在Unicamp临床医院住院的患者的支气管肺泡灌洗液，这些样本中有12/71（16.9％）导致半乳甘露聚糖侧流试验呈阳性，相比之下,半乳甘露聚糖酶免疫测定结果为9/71(12.6%)样品阳性,差异显示无统计学意义(p值=0.36)比较两种测定的结果确定了它们之间的8个差异,约占总样本的11%。敏感度（73.3%），特异性（92.35%），使用半乳甘露聚糖酶免疫测定作为标准计算侧流测定的阳性预测值(62.85%)和阴性预测值(95.15%)。与酶免疫测定相比,侧流测定显示出良好的结果。
