Delama Ignacio, Legarraga Paulette, González Tamara, García Patricia, Rabagliati Ricardo
Departamento de Enfermedades Infecciosas del adulto, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Departamento de Laboratorios Clínicos, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Rev Chilena Infectol. 2018;35(5):574-579. doi: 10.4067/s0716-10182018000500574.
The incidence of invasive aspergillosis is increasing. Its diagnosis is based on clinical and microbiological criteria which include the determination of serological markers such as galactomannan. Recently, the Aspergillus lateral flow device, an inmunocromatograph assay has been described for its diagnosis.
To evaluate the performance of the lateral flow device for the diagnosis of invasive aspergillosis (IA) in adult patients.
In this cross-sectional study, frozen samples that had been previously evaluated for galactomannan from patients classified with proven/probable/possible or no AI according to the EORTC/MSG criteria were selected.
A total of 142 samples from 98 patients were processed, corresponding to proven AI 5.6%, probable IA 41.5%, possible IA 12.7% and no-IA 40.1%. The sensitivity and specificity of the Aspergillus lateral flow was 70.9% and 53.5% for serum samples and 83.3% and 38.5% for BAL samples. The concordance between the galactomannan and Aspergillus lateral flow was 62.4% (54.1 - 69.9) with a Kappa index of 0.202 (0.03682 - 0.3669).
We observed a good sensitivity but low specificity, a positive result need a confirmatory test.
侵袭性曲霉病的发病率正在上升。其诊断基于临床和微生物学标准，其中包括测定半乳甘露聚糖等血清学标志物。最近，已描述了一种用于诊断的曲霉侧流装置，即免疫层析测定法。
评估侧流装置在成年患者中诊断侵袭性曲霉病（IA）的性能。
在这项横断面研究中，选择了先前根据EORTC/MSG标准被分类为确诊/很可能/可能患有或未患有AI的患者的半乳甘露聚糖冷冻样本。
共处理了来自98名患者的142个样本，对应确诊AI为5.6%，很可能患有IA为41.5%，可能患有IA为12.7%，未患有IA为40.1%。曲霉侧流装置对血清样本的敏感性和特异性分别为70.9%和53.5%，对支气管肺泡灌洗（BAL）样本分别为83.3%和38.5%。半乳甘露聚糖与曲霉侧流装置之间的一致性为62.4%（54.1 - 69.9），Kappa指数为0.202（0.03682 - 0.3669）。
我们观察到敏感性良好但特异性较低，阳性结果需要进行确证试验。
