Performance of the Euroimmun Aspergillus Antigen ELISA for the Diagnosis of Invasive Pulmonary Aspergillosis in Bronchoalveolar Lavage Fluid.
Date
2022-04
Editor
Hanson, Kimberly E
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Abstract
Invasive pulmonary aspergillosis (IPA) is a life-threatening disease that affects
mainly immunocompromised hosts. Galactomannan testing from serum and bronchoalveolar
lavage fluid (BALF) represents a cornerstone in diagnosing the disease. Here, we evaluated
the diagnostic performance of the novel Aspergillus-specific galactomannoprotein (GP) enzyme-linked immunosorbent assay (ELISA; Euroimmun
Medizinische Labordiagnostika) compared with the established Platelia Aspergillus GM ELISA (GM; Bio-Rad Laboratories) for the detection of Aspergillus antigen in BALF. Using the GP ELISA, we retrospectively tested 115 BALF samples from
115 patients with clinical suspicion of IPA and GM analysis ordered in clinical routine.
Spearman's correlation statistics and receiver operating characteristics (ROC) curve
analysis were performed. Optimal cutoff values were determined using Youden's index.
Of 115 patients, 1 patient fulfilled criteria for proven IPA, 42 for probable IPA,
15 for putative IPA, 10 for possible IPA, and 47 did not meet criteria for IPA. Sensitivities
and specificities for differentiating proven/probable/putative versus no IPA (possible
excluded) were 74% and 96% for BALF GP and 90% and 96% for BALF GM at the manufacturer-recommended
cutoffs. Using the calculated optimal cutoff value of 12 pg/mL, sensitivity and specificity
of the BALF GP were 90% and 96%, respectively. ROC curve analysis showed an area under
the curve (AUC) of 0.959 (95% confidence interval [CI] of 0.923 to 0.995) for the
GP ELISA and an AUC of 0.960 (95% CI of 0.921 to 0.999) for the GM ELISA for differentiating
proven/probable/putative IPA versus no IPA. Spearman's correlation analysis showed
a strong correlation between the ELISAs (rho = 0.809, P < 0.0001). The GP ELISA demonstrated strong correlation and test performance similar
to that of the GM ELISA and could serve as an alternative test for BALF from patients
at risk for IPA.
Type
Journal articleSubject
Bronchoalveolar Lavage FluidHumans
Aspergillus
Mannans
Antigens, Fungal
Enzyme-Linked Immunosorbent Assay
Sensitivity and Specificity
Retrospective Studies
Invasive Pulmonary Aspergillosis
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https://hdl.handle.net/10161/28599Published Version (Please cite this version)
10.1128/jcm.00215-22Publication Info
Egger, Matthias; Penziner, Samuel; Dichtl, Karl; Gornicec, Max; Kriegl, Lisa; Krause,
Robert; ... Hoenigl, Martin (2022). Performance of the Euroimmun Aspergillus Antigen ELISA for the Diagnosis of Invasive
Pulmonary Aspergillosis in Bronchoalveolar Lavage Fluid. Journal of clinical microbiology, 60(4). pp. e0021522. 10.1128/jcm.00215-22. Retrieved from https://hdl.handle.net/10161/28599.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Jeffrey Daniel Jenks
Adjunct Associate Professor in the Department of Medicine

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