eprintid: 19357
rev_number: 36
eprint_status: archive
userid: 1589
dir: disk0/00/01/93/57
datestamp: 2015-11-30 14:03:17
lastmod: 2024-05-03 08:27:51
status_changed: 2015-11-30 14:03:17
type: article
metadata_visibility: show
creators_name: Eigl, Susanne
creators_name: Prattes, Jürgen
creators_name: Lackner, Michaela
creators_name: Willinger, Birgit
creators_name: Spiess, Birgit
creators_name: Reinwald, Mark
creators_name: Selitsch, Brigitte
creators_name: Meilinger, Michael
creators_name: Neumeister, Peter
creators_name: Reischies, Frederike
creators_name: Wölfler, Albert
creators_name: Raggam, Reinhard B.
creators_name: Flick, Holger
creators_name: Eschertzhuber, Stephan
creators_name: Krause, Robert
creators_name: Buchheidt, Dieter
creators_name: Thornton, Christopher R.
creators_name: Flörl, Cornelia
creators_name: Hoenigl, Martin
title: Multicenter evaluation of a lateral-flow device test for diagnosing invasive pulmonary aspergillosis in ICU patients
subjects: ddc-610
divisions: i-61200
abstract: Introduction: The incidence of invasive pulmonary aspergillosis (IPA) in intensive care unit (ICU) patients is increasing, and early diagnosis of the disease and treatment with antifungal drugs is critical for patient survival. Serum biomarker tests for IPA typically give false-negative results in non-neutropenic patients, and galactomannan (GM) detection, the preferred diagnostic test for IPA using bronchoalveolar lavage (BAL), is often not readily available. Novel approaches to IPA detection in ICU patients are needed. In this multicenter study, we evaluated the performance of an Aspergillus lateral-flow device (LFD) test for BAL IPA detection in critically ill patients.   Methods: A total of 149 BAL samples from 133 ICU patients were included in this semiprospective study. Participating centers were the medical university hospitals of Graz, Vienna and Innsbruck in Austria and the University Hospital of Mannheim, Germany. Fungal infections were classified according to modified European Organization for Research and Treatment of Cancer/Mycoses Study Group criteria.   Results: Two patients (four BALs) had proven IPA, fourteen patients (sixteen BALs) had probable IPA, twenty patients (twenty-one BALs) had possible IPA and ninety-seven patients (one hundred eight BALs) did not fulfill IPA criteria. Sensitivity, specificity, negative predictive value, positive predictive value and diagnostic odds ratios for diagnosing proven and probable IPA using LFD tests of BAL were 80%, 81%, 96%, 44% and 17.6, respectively. Fungal BAL culture exhibited a sensitivity of 50% and a specificity of 85%.   Conclusion: LFD tests of BAL showed promising results for IPA diagnosis in ICU patients. Furthermore, the LFD test can be performed easily and provides rapid results. Therefore, it may be a reliable alternative for IPA diagnosis in ICU patients if GM results are not rapidly available.   Trial registration: ClinicalTrials.gov NCT02058316. Registered 20 January 2014.
date: 2015
publisher: BioMed Central
id_scheme: DOI
ppn_swb: 1653537256
own_urn: urn:nbn:de:bsz:16-heidok-193575
language: eng
bibsort: EIGLSUSANNMULTICENTE2015
full_text_status: public
publication: Critical care
volume: 19
number: 178
place_of_pub: London
pagerange: 1-9
issn: 1466-609X
citation:   Eigl, Susanne ; Prattes, Jürgen ; Lackner, Michaela ; Willinger, Birgit ; Spiess, Birgit ; Reinwald, Mark ; Selitsch, Brigitte ; Meilinger, Michael ; Neumeister, Peter ; Reischies, Frederike ; Wölfler, Albert ; Raggam, Reinhard B. ; Flick, Holger ; Eschertzhuber, Stephan ; Krause, Robert ; Buchheidt, Dieter ; Thornton, Christopher R. ; Flörl, Cornelia ; Hoenigl, Martin  (2015) Multicenter evaluation of a lateral-flow device test for diagnosing invasive pulmonary aspergillosis in ICU patients.  Critical care, 19 (178).  pp. 1-9.  ISSN 1466-609X     
document_url: https://archiv.ub.uni-heidelberg.de/volltextserver/19357/1/13054_2015_Article_905.pdf