Retrospective Multicenter Evaluation of the VirClia Galactomannan Antigen Assay for the Diagnosis of Pulmonary Aspergillosis with Bronchoalveolar Lavage Fluid Samples from Patients with Hematological Disease

Buil, Jochem B.; Huygens, Sammy; Dunbar, Albert; Schauwvlieghe, Alexander; Langerak, Diana; Dijk, Karin van; Bruns, Anke H. W.; Haas, Pieter-Jan; Postma, Douwe F.; Biemond, Bart J.; Delma, Fatima Zohra; Kort, Elizabeth de; Melchers, Willem J. G.; Verweij, Paul E.; Rijnders, Bart J. A.

doi:10.1128/jcm.00044-23

Cited by 12 publications

(3 citation statements)

References 19 publications

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“…In a large multicenter study including 141 patients of which 66 cases are probable IPA, the VirClia correlated well with the Platelia for detecting GM in BALF. 34 This was also found in two smaller cohorts in BALF and serum 35 36 but more extensive validation of the test and its cutoffs in serum are needed.…”

Section: Expanding Antigen Detection Testingmentioning

confidence: 85%

Microbiological Diagnosis of Pulmonary Aspergillus Infections

Aerts,

Feys,

Mercier

et al. 2024

Semin Respir Crit Care Med

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As microbiological tests play an important role in our diagnostic algorithms and clinical approach towards patients at-risk for pulmonary aspergillosis, a good knowledge of the diagnostic possibilities and especially their limitations is extremely important. In this review, we aim to reflect critically on the available microbiological diagnostic modalities for diagnosis of pulmonary aspergillosis and formulate some future prospects. Timely start of adequate antifungal treatment leads to a better patient outcome, but overuse of antifungals should be avoided. Current diagnostic possibilities are expanding, and are mainly driven by enzyme immunoassays and lateral flow device tests for the detection of Aspergillus antigens. Most of these tests are directed towards similar antigens, but new antibodies towards different targets are under development. For chronic forms of pulmonary aspergillosis, anti-Aspergillus IgG antibodies and precipitins remain the cornerstone. More studies on the possibilities and limitations of molecular testing including targeting resistance markers are ongoing. Also, metagenomic next-generation sequencing is expanding our future possibilities. It remains important to combine different test results and interpret them in the appropriate clinical context to improve performance. Test performances may differ according to the patient population and test results may be influenced by timing, the tested matrix, and prophylactic and empiric antifungal therapy. Despite the increasing armamentarium, a simple blood or urine test for the diagnosis of aspergillosis in all patient populations at-risk is still lacking. Research on diagnostic tools is broadening from a pathogen focus on biomarkers related to the patient and its immune system.

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Section: Expanding Antigen Detection Testingmentioning

confidence: 85%

Microbiological Diagnosis of Pulmonary Aspergillus Infections

Aerts,

Feys,

Mercier

et al. 2024

Semin Respir Crit Care Med

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“…Some have been shown to have a diagnostic accuracy comparable to the Platelia test described above. 120 121…”

Section: Clinical Presentation and Diagnosismentioning

confidence: 99%

“…Some have been shown to have a diagnostic accuracy comparable to the Platelia test described above. 120,121 Beta(1-3)-D-glucan Beta(1-3)-D-glucan (BDG) is part of the cell wall of many fungi. Its poor specificity precludes its use to diagnose IA and it is currently not retained in the EORTC/MSGERC diagnostic criteria.…”

Section: Galactomannanmentioning

confidence: 99%

Acute Invasive Pulmonary Aspergillosis: Clinical Presentation and Treatment

Heylen,

Vanbiervliet,

Maertens

et al. 2024

Semin Respir Crit Care Med

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Among all clinical manifestations of pulmonary aspergillosis, invasive pulmonary aspergillosis (IPA) is the most acute presentation. IPA is caused by Aspergillus hyphae invading the pulmonary tissue, causing either tracheobronchitis and/or bronchopneumonia. The degree of fungal invasion into the respiratory tissue can be seen as a spectrum, going from colonization to deep tissue penetration with angio-invasion, and largely depends on the host's immune status. Patients with prolonged, severe neutropenia and patients with graft-versus-host disease are at particularly high risk. However, IPA also occurs in other groups of immunocompromised and nonimmunocompromised patients, like solid organ transplant recipients or critically ill patients with severe viral disease. While a diagnosis of proven IPA is challenging and often warranted by safety and feasibility, physicians must rely on a combination of clinical, radiological, and mycological features to assess the likelihood for the presence of IPA. Triazoles are the first-choice regimen, and the choice of the drug should be made on an individual basis. Adjunctive therapy such as immunomodulatory treatment should also be taken into account. Despite an improving and evolving diagnostic and therapeutic armamentarium, the burden and mortality of IPA still remains high. This review aims to give a comprehensive and didactic overview of the current knowledge and best practices regarding the epidemiology, clinical presentation, diagnosis, and treatment of acute IPA.

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Serological Diagnosis of Fungal Infections

Lindsley

2024

Manual of Molecular and Clinical Laboratory Immunology

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Retrospective Multicenter Evaluation of the VirClia Galactomannan Antigen Assay for the Diagnosis of Pulmonary Aspergillosis with Bronchoalveolar Lavage Fluid Samples from Patients with Hematological Disease

Cited by 12 publications

References 19 publications

Microbiological Diagnosis of Pulmonary Aspergillus Infections

Microbiological Diagnosis of Pulmonary Aspergillus Infections

Acute Invasive Pulmonary Aspergillosis: Clinical Presentation and Treatment

Serological Diagnosis of Fungal Infections

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