Sensitivity of serum galactomannan antigen in the diagnosis of invasive aspergillosis in patients with obstructive pulmonary diseases (asthma and chronic obstructive pulmonary diseases).

INTRODUCTION

Adverse clinical outcomes often result from the concomitant presence of invasive pulmonary aspergillosis (IPA) in patients with obstructive pulmonary diseases (asthma and chronic obstructive pulmonary diseases (COPD)).

AIM

This work was developed to assess the risk factors (RFs) for patients with concurrent IPA and the diagnostic sensitivity of existing detection methods.

MATERIAL AND METHODS

This was a case control study on patients with acute exacerbation of obstructive pulmonary diseases (OPD) hospitalized from January 2022 to December 2023; patients were categorized into an IPA group ( = 39) and a non-IPA group ( = 37) based on test results. Information about smoking history, diabetes history, usage of broad-spectrum antibiotics (BSAs) and corticosteroids, and serum albumin levels were collected. After univariate analysis, a multivariate logistic regression (MLR) analysis was performed. Additionally, the diagnostic sensitivity and specificity of GM antigen, IgG, and IgM detection were compared.

RESULTS

Prolonged use of BSAs (≥ 2 weeks) and corticosteroids (≥ 3 weeks), along with low albumin levels emerged as independent RFs for concurrent IPA. The sensitivity of GM antigen detection (64.1%) was the highest among the three methods, with specificity slightly lower than IgG detection (75.68%, 81.08%), yet still not reaching the ideal level.

CONCLUSIONS

Risk assessment for asthma and COPD patients with concurrent IPA should encompass an evaluation of prolonged antibiotic and steroid use, along with a comprehensive consideration of nutritional and immune status. Current IPA detection methods should be evaluated in conjunction with clinical conditions to enhance diagnostic accuracy.