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İnvaziv Aspergilloz Şüphesi Olan Hastaların Tanısında Galaktomanan Antijen Test Sonuçlarının Araştırılması

Yıl 2024, Cilt: 15 Sayı: Özel Sayı, 83 - 90, 30.12.2024
https://doi.org/10.30708/mantar.1566653

Öz

Genellikle immünsüpresif bireylerde yüksek mortalite ile seyreden invaziv aspergilloz, Aspergillus türü mantarların sebep olduğu enfeksiyon hastalıktır. Hastalığın klasik tanı yöntemlerinin geç sonuç vermesi tedavide önemli gecikmelere neden olduğu için erken tanıda kullanılan galaktomannan antijeni, Aspergillus türünün hücre duvarında bulunan bir polisakkarittir. Bu çalışmanın amaçı invaziv aspergilloz şüphesi olan hastalarda galaktomannan antijen testinin sonuçlarının değerlendirilmesidir. Çalışmaya invaziv aspergilloz ön tanılı hastalardan galaktomannan antijeni isteğiyle laboratuvara gönderilen serum ve bronkoalveolar lavaj örnekleri dahil edilmiştir. Galaktomannan antijenlerinin tespiti, FACIS-I cihazında Manyetik Boncuk Kaplı Kemilüminesans yöntemi kullanılarak yapılmıştır. Hastaların 867'sinde (%15.3) galaktomannan antijeni pozitifliği saptanmışdır. Pozitif örneklerin 492'si (%56.7) kan, 375 'si (%43.3) bronkoalveolar lavaj olmuştur. Galaktomannan pozitifliği olan hastaların; 282'si (%32.6) lösemi, 167'si (%19.2) pnömoni ve 142'si (%16.3) lenfoma tanısı almıştır. Antijen pozitifliği saptanan örneklerin 343'ü (%39.5) Hematoloji, 292'si (%33.6) Göğüs hastalıkları ve 156'sı (%18,1)'si İç Hastalıkları ünitelerinden gönderilmiştir. Sonuç olarak serum veya bronkoalveolar lavaj örneklerinde galaktomannan düzeylerinin bakılmasının invaziv aspergillozun erken tanı ve tedavisinde yararlı olacağı kanısına varılmıştır. Bu nedenle galaktomannan test sonuçlarının klinik verilerle beraber değerlendirilmesi invaziv aspergilloz enfeksiyonlarında mortalite ve morbiditenin azaltılmasına katkı sağlayacaktır.

Kaynakça

  • Aslan, M., Öz, Y., Akşit, F., Akay M.O., and Aslan, F.K. (2016). Does Multıple Myeloma cause false posıtıve results of the Aspergillus galactomannan assay? O.J.M, 38 (2), 47-50.
  • Bassetti, M., Azoulay, E., Kullberg, B.J., Ruhnke M., Shoham, S., Vazquez, J., Giacobbe, D.R., and Calandra, T.(2021). EORTC/MSGERC definitions of ınvasive fungal diseases: summary of activities of the ıntensive care unit working group. Clin. Infect. Dis, 72(2), S121-S127.
  • Chowdhury T.C., M., Singh, G., Pandey, M., Mishra, H., Meena, V.P., Sethi, P., Singh, A., Prakash, B., Upadhyay, A.D., Mohan, A., Sinha, S., Xess, I., Wig, N., Kabra, S.K., and Ray, A. (2023). The utility of galactomannan and polymerase chain reaction assays in Bronchoalveolar lavage for diagnosis of chronic pulmonary Aspergillosis. Mycopathologia, 188(6), 1041-1053.
  • Cornely, O.A. (2014). Galactomannan testing during mold-active prophylaxis. Clin. Infect. Dis, 59 (12), 1703-1704.
  • De Heer, K., Gerritsen, M.G., Visser, C.E., and Leeflang, M.M. (2019). Galactomannan detection in broncho-alveolar lavage fluid for invasive aspergillosis in immunocompromised patients. Cochrane. Database. Syst. Rev, 5(5):CD012399.
  • Denning, D.W., Cadranel, J., Beigelman-Aubry, C., Ader, F., Chakrabarti, A., Blot, S., Ullmann, A.J., Dimopoulos, G., Lange, C., and European Society for Clinical Microbiology and Infectious Diseases and European Respiratory Society. (2016). Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management. Eur. Respir. J, 47(1), 45-68.
  • Duarte, R.F., Sánchez-Ortega, I., Cuesta, I., Arnan M., Patino B., Fernández de Sevilla A., Gudiol C., Ayats J., and Cuenca-Estrella, M. (2014). Serum galactomannanbased early detection of invasive aspergillosis in hematology patients receiving effective antimold prophylaxis. Clin. Infect. Dis, 59 (12), 1696-1702.
  • Guegan, H., Robert-Gangneux, F., Camus, C., Belaz, S., Marchand, T., Baldeyrou, M., and Gangneux, J.P. (2018). Improving the diagnosis of invasive aspergillosis by the detection of Aspergillus in broncho-alveolar lavage fluid: comparison of non-culture-based assays. J. Infect, 76(2), 196-220.
  • Haydour, Q., Hage, C.A., Carmona, E.M., Epelbaum. O., Evans S.E., Gabe, L.M., Knox, K.S., Kolls, J.K, Wengenack, N.L., Prokop, L.J., Limper, A.H., and Murad, M.H.(2019). Diagnosis of fungal infections. A systematic review and meta-analysis supporting american thoracic society practice guideline. Ann. Am. Thorac. Soc, 16(9),1179-1188.
  • Kono, Y., Tsushima, K., Yamaguchi, K., Kurita, N., Soeda, S., Fujiwara, A., Sugiyama, S., Togashi, Y., Kasagi, S., To, M., To, Y., and Setoguchi, Y. (2013). The utility of galactomannan antigen in the bronchial washing and serum for diagnosing pulmonary aspergillosis. Respir. Med, 107, 1094-1100.
  • Kontoyiannis, D.P., Marr, K.A., Park, B.J., Alexander, B.D., Anaissie, E.J., Walsh, T.J., Ito, J., Andes,D.R., Baddley,J.W., Brown, J.M., Brumble, L.M., Freifeld,A.G., Hadley, S., Herwaldt, L.A., Kauffman,C.A., Knapp, K., Lyon, G.M., Morrison, V.A., Papanicolaou, G.,Patterson, T.F., Perl,T.M., Schuster,M.G., Walker, R., Wannemuehler, K.A., Wingard, J.R., Chiller, T.M., and Pappas, P.G.(2010). Prospective surveillance for invasive fungal infections in hematopoietic stem cell transplant recipients, 2001-2006: overview of the Transplant-Associated Infection Surveillance Network (TRANSNET) Database. Clin. Infect. Dis, 50(8), 1091-1100.
  • Lai, G., Zeng, C., Mo, J., Song, W.D., and Xu, P. (2020). Diagnostic value of galactomannan in Bronchoalveolar lavage fluid for chronic respiratory disease with pulmonary Aspergillosis. J. Clin. Microbiol, 58, e01308-e01319.
  • Lehrnbecher, T., Phillips, R., Alexander, S., Alvaro, F., Carlesse, F., Fisher, B., Hakim, H., Santolaya, M., Castagnola, E., Davis, B.L., Dupuis,L.L., Gibson, F., Groll A.H., Gaur, A., Gupta, A., Kebudi, R., Petrilli, S., Steinbach, W.J., Villarroel, M., Zaoutis, T., Sung, L., and International Pediatric Fever and Neutropenia Guideline Panel. (2012). Guideline for the management of fever and neutropenia in children with cancer and/ or undergoing hematopoietic stem-cell transplantation. J. Clin. Oncol, 30: 4427–4438.
  • Limper, A.H., Knox, K.S., Sarosi, G.A., Ampel, N.M., Bennett, J.E., Catanzaro, A., Davies, S.F., Dismukes, W.E., Hage, C.A., Marr, K.A., Mody, C.H., Perfect, J.R., Stevens, D.A., and American Thoracic Society Fungal Working Group. (2011). An official American Thoracic Society statement: Treatment of fungal infections in adult pulmonary and critical care patients. Am. J. Respir. Crit. Care. Med, 183 (1), 96-128.
  • Mennink-Kersten, M.A., Ruegebrink, D., Klont, R.R., Warris, A., Gavini, F., Op den Camp, H.J.M., and Verweij, P.E. (2005). Bifidobacterial lipoglycan as a new cause for false-positive Platelia Aspergillus enzyme-linked immunosorbent assay reactivity. J. Clin. Microbiol, 43 (8), 3925–3931.
  • Oz, Y., and Kiraz, N. (2011). Diagnostic methods for fungal infections in pediatric patients: microbiological, serological and molecular methods. Expert. Rev. Anti. Infect. Ther, 9(3), 289-298.
  • Ray, A., Chowdhury, M., Sachdev, J., Sethi, P., Meena, V.P., Singh, G., Xess, I., Vyas, S., Khan, M.A., Sinha, S., Denning, D.W., Wig, N., and Kabra, S.K. (2022). Efficacy of LD Bio Aspergillus ICT Lateral Flow Assay for serodiagnosis of Chronic Pulmonary Aspergillosis. J. Fungi, 8(4), 400.
  • Sav, H., Koç, N., Atalay, M.A., Yıldız, O., and Demir, G. (2014). Investigation of various methods in the diagnosis of systemic aspergillosis. Flora ,19(2), 66-73.
  • Schweer, K.E., Bangard, C., Hekmat, K., and Cornely, O.A. (2014). Chronic pulmonary aspergillosis. Mycoses, 57(5), 257-270.
  • Tanase, A.D., Colita, A., Marculescu, A., Berteanu, C., Streinu, Cercel, A., Stoica, M., Stoica, A., Cernea, D., Copotoiu, S., Brînzaniuc, K., and Azamfirei, L. (2012). Using the galactomannan antigen assay in the diagnosis of invasive aspergillosis after hematopoietic stem cell transplantation. Rom. J. Morphol. Embryol, 53:379-382.
  • Vena, A., Bouza, E., Álvarez-Uría, A., Gayoso, J., Martín-Rabadán, P., Cajuste, F., Guinea, J., Gómez Castellá, J., Alonso, R., and Munoz, P. (2017). The misleading effect of serum galactomannan testing in high-risk haematology patients receiving prophylaxis with micafungin. Clin. Microbiol. Infect, 23(12),1000.e1-1000.e4.
  • Ye, F., Zeng, P., Li, Z., Tang, C., Liu, W., Su, D., Zhan, Y., and Li, S. (2021). Detection of Aspergillus DNA in BALF by real-time PCR and galactomannan antigen for the early diagnosis of chronic pulmonary Aspergillosis. Ann. Clin. Lab. Sci, 51(5), 698-704.

Examination of Galactomannan Antigen Test Results in the Diagnosis of Patients with Suspect of Invasive Aspergillosis

Yıl 2024, Cilt: 15 Sayı: Özel Sayı, 83 - 90, 30.12.2024
https://doi.org/10.30708/mantar.1566653

Öz

Invasive aspergillosis is an infectious disease caused by fungi from the Aspergillus species, and it typically has a high mortality rate among immunosuppressed individuals. Galactomannan antigen (GM) is a polysaccharide found in the cell wall of Aspergillus species and is used for early diagnosis, as traditional diagnostic methods often lead to significant delays in treatment. This study aimed to evaluate the results of galactomannan antigen testing in patients suspected of having invasive aspergillosis. Serum and bronchoalveolar lavage samples from patients with a preliminary diagnosis of invasive aspergillosis were sent to the laboratory for GM antigen testing. The GM antigens were detected using the Magnetic Bead-Coated Chemiluminescence method on the FACIS-I device. Galactomannan antigen positivity was found in 867 (15.3%) of the patients, with 492 (56.7%) of the positive samples coming from blood and 375 (43.3%) from bronchoalveolar lavage. Of the patients with positive galactomannan results, 282 (32.6%) were diagnosed with leukemia, 167 (19.2%) with pneumonia, and 142 (16.3%) with lymphoma. Among the samples that tested positive for the antigen, 343 (39.5%) were sent from Hematology, 292 (33.6%) from Chest Diseases, and 156 (18.1%) from Internal Medicine units. In conclusion, measuring galactomannan levels in serum or bronchoalveolar lavage samples can aid in the early diagnosis and treatment of invasive aspergillosis. Therefore, evaluating galactomannan test results may help reduce mortality and morbidity associated with invasive aspergillosis infections.

Kaynakça

  • Aslan, M., Öz, Y., Akşit, F., Akay M.O., and Aslan, F.K. (2016). Does Multıple Myeloma cause false posıtıve results of the Aspergillus galactomannan assay? O.J.M, 38 (2), 47-50.
  • Bassetti, M., Azoulay, E., Kullberg, B.J., Ruhnke M., Shoham, S., Vazquez, J., Giacobbe, D.R., and Calandra, T.(2021). EORTC/MSGERC definitions of ınvasive fungal diseases: summary of activities of the ıntensive care unit working group. Clin. Infect. Dis, 72(2), S121-S127.
  • Chowdhury T.C., M., Singh, G., Pandey, M., Mishra, H., Meena, V.P., Sethi, P., Singh, A., Prakash, B., Upadhyay, A.D., Mohan, A., Sinha, S., Xess, I., Wig, N., Kabra, S.K., and Ray, A. (2023). The utility of galactomannan and polymerase chain reaction assays in Bronchoalveolar lavage for diagnosis of chronic pulmonary Aspergillosis. Mycopathologia, 188(6), 1041-1053.
  • Cornely, O.A. (2014). Galactomannan testing during mold-active prophylaxis. Clin. Infect. Dis, 59 (12), 1703-1704.
  • De Heer, K., Gerritsen, M.G., Visser, C.E., and Leeflang, M.M. (2019). Galactomannan detection in broncho-alveolar lavage fluid for invasive aspergillosis in immunocompromised patients. Cochrane. Database. Syst. Rev, 5(5):CD012399.
  • Denning, D.W., Cadranel, J., Beigelman-Aubry, C., Ader, F., Chakrabarti, A., Blot, S., Ullmann, A.J., Dimopoulos, G., Lange, C., and European Society for Clinical Microbiology and Infectious Diseases and European Respiratory Society. (2016). Chronic pulmonary aspergillosis: rationale and clinical guidelines for diagnosis and management. Eur. Respir. J, 47(1), 45-68.
  • Duarte, R.F., Sánchez-Ortega, I., Cuesta, I., Arnan M., Patino B., Fernández de Sevilla A., Gudiol C., Ayats J., and Cuenca-Estrella, M. (2014). Serum galactomannanbased early detection of invasive aspergillosis in hematology patients receiving effective antimold prophylaxis. Clin. Infect. Dis, 59 (12), 1696-1702.
  • Guegan, H., Robert-Gangneux, F., Camus, C., Belaz, S., Marchand, T., Baldeyrou, M., and Gangneux, J.P. (2018). Improving the diagnosis of invasive aspergillosis by the detection of Aspergillus in broncho-alveolar lavage fluid: comparison of non-culture-based assays. J. Infect, 76(2), 196-220.
  • Haydour, Q., Hage, C.A., Carmona, E.M., Epelbaum. O., Evans S.E., Gabe, L.M., Knox, K.S., Kolls, J.K, Wengenack, N.L., Prokop, L.J., Limper, A.H., and Murad, M.H.(2019). Diagnosis of fungal infections. A systematic review and meta-analysis supporting american thoracic society practice guideline. Ann. Am. Thorac. Soc, 16(9),1179-1188.
  • Kono, Y., Tsushima, K., Yamaguchi, K., Kurita, N., Soeda, S., Fujiwara, A., Sugiyama, S., Togashi, Y., Kasagi, S., To, M., To, Y., and Setoguchi, Y. (2013). The utility of galactomannan antigen in the bronchial washing and serum for diagnosing pulmonary aspergillosis. Respir. Med, 107, 1094-1100.
  • Kontoyiannis, D.P., Marr, K.A., Park, B.J., Alexander, B.D., Anaissie, E.J., Walsh, T.J., Ito, J., Andes,D.R., Baddley,J.W., Brown, J.M., Brumble, L.M., Freifeld,A.G., Hadley, S., Herwaldt, L.A., Kauffman,C.A., Knapp, K., Lyon, G.M., Morrison, V.A., Papanicolaou, G.,Patterson, T.F., Perl,T.M., Schuster,M.G., Walker, R., Wannemuehler, K.A., Wingard, J.R., Chiller, T.M., and Pappas, P.G.(2010). Prospective surveillance for invasive fungal infections in hematopoietic stem cell transplant recipients, 2001-2006: overview of the Transplant-Associated Infection Surveillance Network (TRANSNET) Database. Clin. Infect. Dis, 50(8), 1091-1100.
  • Lai, G., Zeng, C., Mo, J., Song, W.D., and Xu, P. (2020). Diagnostic value of galactomannan in Bronchoalveolar lavage fluid for chronic respiratory disease with pulmonary Aspergillosis. J. Clin. Microbiol, 58, e01308-e01319.
  • Lehrnbecher, T., Phillips, R., Alexander, S., Alvaro, F., Carlesse, F., Fisher, B., Hakim, H., Santolaya, M., Castagnola, E., Davis, B.L., Dupuis,L.L., Gibson, F., Groll A.H., Gaur, A., Gupta, A., Kebudi, R., Petrilli, S., Steinbach, W.J., Villarroel, M., Zaoutis, T., Sung, L., and International Pediatric Fever and Neutropenia Guideline Panel. (2012). Guideline for the management of fever and neutropenia in children with cancer and/ or undergoing hematopoietic stem-cell transplantation. J. Clin. Oncol, 30: 4427–4438.
  • Limper, A.H., Knox, K.S., Sarosi, G.A., Ampel, N.M., Bennett, J.E., Catanzaro, A., Davies, S.F., Dismukes, W.E., Hage, C.A., Marr, K.A., Mody, C.H., Perfect, J.R., Stevens, D.A., and American Thoracic Society Fungal Working Group. (2011). An official American Thoracic Society statement: Treatment of fungal infections in adult pulmonary and critical care patients. Am. J. Respir. Crit. Care. Med, 183 (1), 96-128.
  • Mennink-Kersten, M.A., Ruegebrink, D., Klont, R.R., Warris, A., Gavini, F., Op den Camp, H.J.M., and Verweij, P.E. (2005). Bifidobacterial lipoglycan as a new cause for false-positive Platelia Aspergillus enzyme-linked immunosorbent assay reactivity. J. Clin. Microbiol, 43 (8), 3925–3931.
  • Oz, Y., and Kiraz, N. (2011). Diagnostic methods for fungal infections in pediatric patients: microbiological, serological and molecular methods. Expert. Rev. Anti. Infect. Ther, 9(3), 289-298.
  • Ray, A., Chowdhury, M., Sachdev, J., Sethi, P., Meena, V.P., Singh, G., Xess, I., Vyas, S., Khan, M.A., Sinha, S., Denning, D.W., Wig, N., and Kabra, S.K. (2022). Efficacy of LD Bio Aspergillus ICT Lateral Flow Assay for serodiagnosis of Chronic Pulmonary Aspergillosis. J. Fungi, 8(4), 400.
  • Sav, H., Koç, N., Atalay, M.A., Yıldız, O., and Demir, G. (2014). Investigation of various methods in the diagnosis of systemic aspergillosis. Flora ,19(2), 66-73.
  • Schweer, K.E., Bangard, C., Hekmat, K., and Cornely, O.A. (2014). Chronic pulmonary aspergillosis. Mycoses, 57(5), 257-270.
  • Tanase, A.D., Colita, A., Marculescu, A., Berteanu, C., Streinu, Cercel, A., Stoica, M., Stoica, A., Cernea, D., Copotoiu, S., Brînzaniuc, K., and Azamfirei, L. (2012). Using the galactomannan antigen assay in the diagnosis of invasive aspergillosis after hematopoietic stem cell transplantation. Rom. J. Morphol. Embryol, 53:379-382.
  • Vena, A., Bouza, E., Álvarez-Uría, A., Gayoso, J., Martín-Rabadán, P., Cajuste, F., Guinea, J., Gómez Castellá, J., Alonso, R., and Munoz, P. (2017). The misleading effect of serum galactomannan testing in high-risk haematology patients receiving prophylaxis with micafungin. Clin. Microbiol. Infect, 23(12),1000.e1-1000.e4.
  • Ye, F., Zeng, P., Li, Z., Tang, C., Liu, W., Su, D., Zhan, Y., and Li, S. (2021). Detection of Aspergillus DNA in BALF by real-time PCR and galactomannan antigen for the early diagnosis of chronic pulmonary Aspergillosis. Ann. Clin. Lab. Sci, 51(5), 698-704.
Toplam 22 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Mikoloji
Bölüm ARAŞTIRMA MAKALESİ
Yazarlar

Salih Maçin 0000-0002-1871-3629

Rugıyya Samadzade 0000-0002-7079-8500

Senanur Aydoğan 0000-0002-8766-7777

Duygu Fındık 0000-0002-0342-0364

Yayımlanma Tarihi 30 Aralık 2024
Gönderilme Tarihi 14 Ekim 2024
Kabul Tarihi 3 Aralık 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 15 Sayı: Özel Sayı

Kaynak Göster

APA Maçin, S., Samadzade, R., Aydoğan, S., Fındık, D. (2024). Examination of Galactomannan Antigen Test Results in the Diagnosis of Patients with Suspect of Invasive Aspergillosis. Mantar Dergisi, 15(Özel Sayı), 83-90. https://doi.org/10.30708/mantar.1566653

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