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单次半乳甘露聚糖检测(普立泰利试剂盒)对临床分离出曲霉属真菌的非血液学患者侵袭性曲霉病诊断的价值

Value of a single galactomannan determination (Platelia) for the diagnosis of invasive aspergillosis in non-hematological patients with clinical isolation of Aspergillus spp.

作者信息

Guinea Jesús, Jensen Julia, Peláez Teresa, Gijón Paloma, Alonso Roberto, Rivera Marisa, Muñoz Patricia, Bouza Emilio

机构信息

Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Spain.

出版信息

Med Mycol. 2008 Sep;46(6):575-9. doi: 10.1080/13693780801978968.

Abstract

We studied 75 patients with non-hematological conditions from whom Aspergillus spp. were recovered from clinical specimens during the period March 2003 to August 2006. The patients were classified according to EORTC criteria and the presence of galactomannan (Platelia Aspergillus) in their sera was evaluated. Ten of these patients (13.3%) had proven or probable invasive aspergillosis, i.e., chronic obstructive pulmonary disease in five (50%), HIV infection in one (10%), lymphoma in one (10%), liver transplant in one (10%), solid malignancies in one (10%), and corticosteroid treatment in one (10%). The sensitivity, specificity, and positive and negative predictive values for the detection of galactomannan, using cut-offs of > or =0.5 ng/ml and > or =1 ng/ml were 60%/50%, 89.23%/100%, 46.15%/100%, and 93.55%/92.86% (p=0.001 and p<0.001), respectively. The determination of galactomannan in the sera of non-neutropenic patients could prove to be a useful microbiological finding when diagnosing invasive aspergillosis.

摘要

我们研究了75例非血液系统疾病患者,这些患者在2003年3月至2006年8月期间临床标本中分离出曲霉菌属。根据欧洲癌症研究与治疗组织(EORTC)标准对患者进行分类,并评估其血清中半乳甘露聚糖(曲霉ELISA检测试剂盒)的存在情况。其中10例患者(13.3%)确诊或疑似侵袭性曲霉病,即慢性阻塞性肺疾病5例(50%)、HIV感染1例(10%)、淋巴瘤1例(10%)、肝移植1例(10%)、实体恶性肿瘤1例(10%)、接受皮质类固醇治疗1例(10%)。使用≥0.5 ng/ml和≥1 ng/ml的临界值检测半乳甘露聚糖的敏感性、特异性、阳性预测值和阴性预测值分别为60%/50%、89.23%/100%、46.15%/100%和93.55%/92.86%(p = 0.001和p < 0.001)。在诊断侵袭性曲霉病时,测定非中性粒细胞减少患者血清中的半乳甘露聚糖可能是一项有用的微生物学检查结果。

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