Sandwich enzyme-linked immunosorbent assay compared with Pastorex latex agglutination test for diagnosing invasive aspergillosis in immunocompromised patients

Verweij, Paul E.; Stynen, D.; Rijs, Antonius J. M. M.; Pauw, B.E. de; Hoogkamp-Korstanje, J. A. A.; Meis, Jacques F.

doi:10.1128/jcm.33.7.1912-1914.1995

Cited by 175 publications

(66 citation statements)

References 18 publications

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“…In our study, 11 of 74 episodes (14AE9%) from the control patient population had an index value of ‡0AE5. The resulting specificity of 85AE1% for a single positive result was significantly lower compared with previously reported specificities using higher cut-off values (Verweij et al, 1995;Sulahian et al, 1996Sulahian et al, , 2001Maertens et al, 1999Maertens et al, , 2001; a similar drop in specificity (from 99AE4% to 88AE7%) has also been reported when the cut-off was reduced from 1AE5 to 0AE6 (Herbrecht et al, 2002b). In addition, accepting a single positive assay of ‡0AE5 as a diagnostic criterion also had a markedly negative impact on PPV and clinical efficiency when compared with a cut-off value of 0AE8, 0AE9 or 1AE0.…”

Section: Static Dynamiccontrasting

confidence: 77%

Prospective clinical evaluation of lower cut‐offs for galactomannan detection in adult neutropenic cancer patients and haematological stem cell transplant recipients

Maertens¹,

Theunissen²,

Verbeken³

et al. 2004

Br J Haematol

161

105

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SummaryThe recent advent of an improved commercial serum enzyme-linked immunosorbent assay (ELISA) for the detection of circulating galactomannan (GM), a major constituent of Aspergillus cell walls, has contributed to the diagnosis of invasive aspergillosis (IA) in many haematology and transplant centres. However, the optimal threshold for positivity remains a matter of debate. We prospectively evaluated the impact of lowering the cut-off in 124 neutropenic episodes with a high pretest probability for IA. Two new cut-off points, lower than previously accepted, are proposed: (a) a 'static' cut-off at 0AE8 and (b) a 'dynamic' cut-off at 0AE5. A single assay with an optical density (OD) index ‡0AE8 warrants the initiation of anti-Aspergillus therapy. A further lowering of the 'static' threshold seems not clinically feasible given the drop in positive predictive value (PPV). However, the demonstration of at least two sequential sera with an OD ‡0AE5 ('dynamic' threshold) increased the specificity and the PPV to 98AE6% and the efficiency to 98%. Applying both cut-offs to a subgroup of 21 'possible' fungal infections further identified and upgraded six cases of IA. However, the clinical benefit of lower cut-offs (particularly for earlier diagnosis) depends upon the kinetics of antigenaemia and the intensity of serum sampling.

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Section: Static Dynamiccontrasting

confidence: 77%

Prospective clinical evaluation of lower cut‐offs for galactomannan detection in adult neutropenic cancer patients and haematological stem cell transplant recipients

Maertens¹,

Theunissen²,

Verbeken³

et al. 2004

Br J Haematol

161

105

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“…10 Introducing a sandwich ELISA technique that incorporates the b 1-5 galactofuranosespecific EBA2 monoclonal antibody as detector for GM, Stynen et al showed considerably improved sensitivity rates due to a significantly lower GM detection limit in vitro (1.0 ng ml )1 serum). 11,12 Using this technique to evaluate the test clinically, Maertens et al prospectively screened 2172 serial blood samples from 186 patients with haematological malig-nancies and found, based on histologically and culturally proven invasive infections, sensitivity and specificity rates of 92.6% and 95.4%, respectively; PPV and NPV were 93% and 95%, respectively. False-positive findings occured in 8%.…”

Section: Serological Assays To Diagnose Invasive Aspergillosismentioning

confidence: 99%

Molecular and serological diagnosis of invasive aspergillosis: new answers to old questions?

Hummel¹,

Buchheidt²

2007

Mycoses

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Over the recent years, novel molecular and serological methods have been developed to improve diagnosis of invasive aspergillosis (IA) in patients at high risk for fungal infections, especially patients with malignant haematological diseases undergoing intensive chemotherapy. Early diagnosis and treatment are crucial in the management of fungal infections. However, diagnosis often remains difficult as most of the diagnostic tools in clinical use at present either lack specificity or acceptable sensitivity in the early phase of the infection. The clinical value, advantages and problems of current molecular and serological approaches to diagnose IA are reviewed.

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“…8 Methods like enzyme immunoassay, radioimmunoassay and latex agglutination have been used to identify GM in different specimens. 9,10 Commercial kits (Platelia Ò Aspergillus; Bio-Rad Laboratories, Marnes-la-Coquette, France) that use the monoclonal anti-GM antibody EB-A2 as both capture and peroxidase-linked antibodies in sandwich enzyme-linked immunosorbent assay (ELISA) are available. 10,11 While the specificity of the test is quite high, reported sensitivities in different studies display wide variations.…”

Section: Introductionmentioning

confidence: 99%

Galactomannan on the stage: prospective evaluation of the applicability in routine practice and surveillance

Tanrıöver

Aşçıoğlu

Altun

et al. 2010

Mycoses

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SummaryInvasive aspergillosis (IA) presents a diagnostic and therapeutic dilemma for the physicians who take care of the patients with severe underlying diseases and immunosuppression. This study aimed to evaluate the usefulness of serum galactomannan (GM) measurements in the routine practice and surveillance of IA along with possible caveats in diagnosis and treatment. Adult patients with high-risk haematological malignancies admitted to the Internal Medicine wards during the 2-year study period were followed up by daily visits for vital signs, existing or newly developing signs and symptoms, clinical and laboratory findings. Blood samples were analysed for GM levels by the ELISA method at the end of the study period. Data of 58 hospitalisation episodes in 45 patients were analysed. Proven IA was diagnosed in one patient, probable IA was diagnosed in four patients. The sensitivity was 60% and the specificity was 21% when the index cut-off for positivity was accepted as 0.5. The yield of GM testing may be influenced by many variables and each centre should evaluate the usefulness of this test in its own conditions.

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Sandwich enzyme-linked immunosorbent assay compared with Pastorex latex agglutination test for diagnosing invasive aspergillosis in immunocompromised patients

Cited by 175 publications

References 18 publications

Prospective clinical evaluation of lower cut‐offs for galactomannan detection in adult neutropenic cancer patients and haematological stem cell transplant recipients

Prospective clinical evaluation of lower cut‐offs for galactomannan detection in adult neutropenic cancer patients and haematological stem cell transplant recipients

Molecular and serological diagnosis of invasive aspergillosis: new answers to old questions?

Galactomannan on the stage: prospective evaluation of the applicability in routine practice and surveillance

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