Serum Lateral Flow assay with digital reader for the diagnosis of invasive pulmonary aspergillosis: A two-centre mixed cohort study.

dc.contributor.author

Hoenigl, Martin

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Egger, Matthias

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Boyer, Johannes

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Schulz, Eduard

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Prattes, Juergen

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Jenks, Jeffrey D

dc.date.accessioned

2023-08-01T17:40:41Z

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2023-08-01T17:40:41Z

dc.date.issued

2021-10

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2023-08-01T17:40:41Z

dc.description.abstract

Background

Detection of galactomannan (GM) from bronchoalveolar lavage fluid (BALF) or serum is broadly used for diagnosis of invasive aspergillosis (IA), although the sensitivity of GM from serum is lower in non-neutropenic patients. We evaluated the Aspergillus galactomannan Lateral Flow assay (LFA) with digital readout from serum in a mixed cohort of patients.

Methods

We performed a retrospective two-centre study evaluating the LFA from serum of patients with clinical suspicion of IA obtained between 2015 and 2021 at the University of California San Diego and the Medical University of Graz. The sensitivity and specificity was calculated for proven/probable aspergillosis versus no aspergillosis. Correlation with same-sample GM was calculated using Spearman correlation analysis and kappa statistics.

Results

In total, 122 serum samples from 122 patients were analysed, including proven IA (n = 1), probable IA or coronavirus-associated pulmonary aspergillosis (CAPA) (n = 27), and no IA/CAPA/non-classifiable (n = 94). At a 0.5 ODI cut-off, the sensitivity and specificity of the LFA was 78.6% and 80.5%. Spearman correlation analysis showed a strong correlation between serum LFA ODI and serum GM ODI (ρ 0.459, p < .0001). Kappa was 0.611 when both LFA and GM were used with a 0.5 ODI cut-off, showing substantial agreement (p < .001).

Discussion

The LFA with digital read out from serum showed good performance for the diagnosis of probable/proven aspergillosis, with substantial agreement to GM from serum. Like the LFA from BALF, the LFA from serum may serve as a more rapid test compared to conventional GM, particularly in settings where GM is not readily available.
dc.identifier.issn

0933-7407

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1439-0507

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https://hdl.handle.net/10161/28604

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eng

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Wiley

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Mycoses

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10.1111/myc.13352

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Bronchoalveolar Lavage Fluid

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Humans

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Aspergillus

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Galactose

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Mannans

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Antigens, Fungal

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Diagnostic Tests, Routine

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Immunoassay

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Sensitivity and Specificity

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Retrospective Studies

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Adult

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Aged

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Aged, 80 and over

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Middle Aged

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Female

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Male

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Invasive Pulmonary Aspergillosis

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Young Adult

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Automation, Laboratory

dc.title

Serum Lateral Flow assay with digital reader for the diagnosis of invasive pulmonary aspergillosis: A two-centre mixed cohort study.

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Journal article

duke.contributor.orcid

Jenks, Jeffrey D|0000-0001-6632-9587

pubs.begin-page

1197

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1202

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10

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Duke

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School of Medicine

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Clinical Science Departments

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Medicine

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Medicine, Infectious Diseases

pubs.publication-status

Published

pubs.volume

64

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